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NPI Code Detail

MEDICARE: MS. ROSALIE DEVONSHIRE MSW, LCSW

MEDICARE: MS. ROSALIE DEVONSHIRE MSW, 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 WorkerIL

General Provider Information

NPI Number : 1598853541
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROSALIE DEVONSHIRE MSW, LCSW
Provider Business Mailing Address
First Line : 1610 LUTHER LN
Second Line :
City : PARK RIDGE
State : IL
Zip : 60068-1243
Country : US
Telephone Number : 847-795-3100
Fax Number :
Provider Business Practice Location Address
First Line : 4322 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2144
Country : US
Telephone Number : 773-604-5321
Fax Number : 773-604-5231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 07/13/2007

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