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NPI Code Detail

MEDICARE: KELSEY LAMM ROTTMULLER

MEDICARE: KELSEY LAMM ROTTMULLER
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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1750943098
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY LAMM ROTTMULLER
Provider Business Mailing Address
First Line : 1019 W AINSLIE ST APT 1
Second Line :
City : CHICAGO
State : IL
Zip : 60640-3711
Country : US
Telephone Number : 773-480-3170
Fax Number :
Provider Business Practice Location Address
First Line : 30 N MICHIGAN AVE STE 1217
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3732
Country : US
Telephone Number : 773-480-3170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2019
Last Update Date : 07/08/2019

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Directions to “ KELSEY LAMM ROTTMULLER ” Practice Location

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