Healthcare Provider Details
I. General information
NPI: 1003467499
Provider Name (Legal Business Name): ROSECRANS & ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2019
Last Update Date: 12/14/2023
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1457 MERCHANT DR STE C
ALGONQUIN IL
60102-5917
US
IV. Provider business mailing address
1457 MERCHANT DR STE C
ALGONQUIN IL
60102-5917
US
V. Phone/Fax
- Phone: 847-461-8414
- Fax: 847-461-8387
- Phone: 847-461-8414
- Fax: 847-461-8387
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0004X |
| Taxonomy | Health Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MEGAN
ROSECRANS
Title or Position: PRESIDENT/LICENSED CLINICAL HEALTH
Credential: PSY.D.
Phone: 630-347-8585