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General NPI Number Information
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NPI Number | 1538550819
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Entity Type | Individual
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Provider Name | DANIEL WILLIAM ROSS LCSW
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Gender | Male
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Dates
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Enumeration Date | 02/09/2015
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 1790 NATIONS DR STE 214
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City | GURNEE
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State | IL
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Zip | 60031-9176
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Country | US
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Telephone | 224-501-0479
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Fax |
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Provider Business Mailing Address
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Address Line | 469 ENFIELD LN
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City | GRAYSLAKE
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State | IL
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Zip | 60030-4424
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Country | US
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Telephone | 224-501-0479
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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 | C-10005
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.023744
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License Number State | IL
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