MEDICARE: ERIN ELIZABETH ROHAN LCSW, CADC, CAMS-II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149.019173	IL
2	1041C0700X	Clinical Social Worker	99216	CA

General Provider Information

NPI Number	:	1083189070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN ELIZABETH ROHAN LCSW, CADC, CAMS-II

Provider Business Mailing Address
First Line	:	2232 W 110TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3216
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2232 W 110TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3216
Country	:	US
Telephone Number	:	773-710-7609
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2018
Last Update Date	:	03/16/2021

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