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General NPI Number Information
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NPI Number | 1124274725
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Entity Type | Individual
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Provider Name | MS. CLAUDIA ALISON ROSE
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Gender | Female
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 64 OLD ORCHARD CENTER SUITE # 607
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City | SKOKIE
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State | IL
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Zip | 60077-1425
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Country | US
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Telephone | 773-931-7705
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Fax |
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Provider Business Mailing Address
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Address Line | 640 GROVE ST
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City | GLENCOE
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State | IL
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Zip | 60022-1654
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Country | US
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Telephone | 773-931-7705
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149008406
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License Number State | IL
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