Healthcare Provider Details

I. General information

NPI: 1598509051
Provider Name (Legal Business Name): AALIYAH ROGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W LAKE COOK RD
BUFFALO GROVE IL
60089-1926
US

IV. Provider business mailing address

950 LEE ST
DES PLAINES IL
60016-6532
US

V. Phone/Fax

Practice location:
  • Phone: 847-353-1500
  • Fax:
Mailing address:
  • Phone: 877-486-4140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: