Individual
MS. ANNIE ROSENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
4250 N MARINE DR STE 230, CHICAGO, IL 60613-6209
(773) 549-1978
(773) 248-3638
Mailing address
4250 N MARINE DR STE 230, CHICAGO, IL 60613-6209
(773) 549-1978
(773) 857-0408
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-009164
IL
1041C0700X
Clinical Social Worker
149009164
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01627399
BLUE CROSS & BLUE SHIELD
IL
Enumeration date
10/09/2006
Last updated
02/01/2019
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