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General NPI Number Information
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NPI Number | 1205247806
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Entity Type | Organization
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Legal Business Name | STEPHEN J. ROSENBAUM MSW LCSW PC
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Dates
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Enumeration Date | 05/16/2014
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 1803 SAINT JOHNS AVE
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-3298
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Country | US
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Telephone | 847-432-2355
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Fax |
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Provider Business Mailing Address
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Address Line | 1803 SAINT JOHNS AVE
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-3298
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Country | US
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Telephone | 847-432-2355
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEPHEN J ROSENBAUM
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Credential | MSW
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Telephone | 847-432-2355
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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 | 149-000569
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License Number State | IL
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