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General NPI Number Information
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NPI Number | 1144559519
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Entity Type | Individual
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Provider Name | MICHAEL ROBERT ROSZYK BSW, MSW
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Gender | Male
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 621 EDGEBROOK DR
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City | SHOREWOOD
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State | IL
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Zip | 60404-9742
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Country | US
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Telephone | 815-258-2889
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Fax |
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Provider Business Mailing Address
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Address Line | 621 EDGEBROOK DR
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City | SHOREWOOD
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State | IL
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Zip | 60404-9742
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Country | US
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Telephone | 815-258-2889
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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