Provider Demographics
NPI:1063619302
Name:KILTY, ROSITA E (MS, LCPC)
Entity type:Individual
Prefix:MRS
First Name:ROSITA
Middle Name:E
Last Name:KILTY
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13424 WOOD DUCK DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-7766
Mailing Address - Country:US
Mailing Address - Phone:815-254-7895
Mailing Address - Fax:815-254-7896
Practice Address - Street 1:2272 95TH STREET
Practice Address - Street 2:SUITE 305
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565
Practice Address - Country:US
Practice Address - Phone:630-753-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional