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NPI Code Detail

MEDICARE: STEPHANIE GAIL ROSS, LCSW LCSW

MEDICARE: STEPHANIE GAIL ROSS, LCSW 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 WorkerC-08261NM
21041C0700XClinical Social Worker149.023540IL

General Provider Information

NPI Number : 1144535915
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE GAIL ROSS, LCSW LCSW
Provider Business Mailing Address
First Line : 175 E HAWTHORN PKWY STE 235
Second Line :
City : VERNON HILLS
State : IL
Zip : 60061-1454
Country : US
Telephone Number : 630-428-7890
Fax Number :
Provider Business Practice Location Address
First Line : 175 E HAWTHORN PKWY STE 235
Second Line :
City : VERNON HILLS
State : IL
Zip : 60061-1454
Country : US
Telephone Number : 630-428-7890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2010
Last Update Date : 04/16/2024

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