Provider Demographics
NPI:1104110758
Name:ROSENBERG & ASSOCIATES PROFESSIONAL COUNSELORS LTC
Entity type:Organization
Organization Name:ROSENBERG & ASSOCIATES PROFESSIONAL COUNSELORS LTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:847-749-0514
Mailing Address - Street 1:3325 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:400 B
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1582
Mailing Address - Country:US
Mailing Address - Phone:847-749-0514
Mailing Address - Fax:847-749-2995
Practice Address - Street 1:3325 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:400 B
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1582
Practice Address - Country:US
Practice Address - Phone:847-749-0514
Practice Address - Fax:847-749-2995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180002762251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health