MEDICARE: MS. ROSEANNE NMN BERNARDINI 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
1	1041C0700X	Clinical Social Worker	149-1632	IL

General Provider Information

NPI Number	:	1841208915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSEANNE NMN BERNARDINI MSW LCSW

Provider Business Mailing Address
First Line	:	2835 N SHEFFIELD AVE STE 224
Second Line	:	SHEFFIELD SQUARE PROFESSIONAL BUILDING
City	:	CHICAGO
State	:	IL
Zip	:	60657-5083
Country	:	US
Telephone Number	:	773-975-1166
Fax Number	:

Provider Business Practice Location Address
First Line	:	2835 N SHEFFIELD AVE STE 224
Second Line	:	SHEFFIELD SQUARE PROFESSIONAL BUILDING
City	:	CHICAGO
State	:	IL
Zip	:	60657-5083
Country	:	US
Telephone Number	:	773-975-1166
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/08/2007

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