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NPI Code Detail

MEDICARE: MS. LAUREN CHAVA ROSE LCSW

MEDICARE:  MS. LAUREN CHAVA ROSE  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker149014909IL

General Provider Information

NPI Number : 1053697342
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAUREN CHAVA ROSE LCSW
Provider Business Mailing Address
First Line : 4719 N WINCHESTER AVE
Second Line : APARTMENT 3D
City : CHICAGO
State : IL
Zip : 60640-4349
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4719 N WINCHESTER AVE
Second Line : APARTMENT 3D
City : CHICAGO
State : IL
Zip : 60640-4349
Country : US
Telephone Number : 847-736-1667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2011
Last Update Date : 08/05/2022

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Directions to “ MS. LAUREN CHAVA ROSE LCSW” Practice Location

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