Healthcare Provider Details

I. General information

NPI: 1346158870
Provider Name (Legal Business Name): JOSHUA ROGOZ CADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 FLORENCE AVE
JOLIET IL
60433-2002
US

IV. Provider business mailing address

704 FLORENCE AVE
JOLIET IL
60433-2002
US

V. Phone/Fax

Practice location:
  • Phone: 708-759-5546
  • Fax:
Mailing address:
  • Phone: 708-759-5546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCADC-45329
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: