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Individual

DR. SUZANNE G. ROSENTHAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
901 EDGEMERE CT, EVANSTON, IL 60202-1428
(847) 491-1670
(847) 491-1679
Mailing address
901 EDGEMERE CT, EVANSTON, IL 60202-1428
(847) 491-1670
(847) 491-1679

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01673622
BLUECROSS&BLUESHIELD
IL
Enumeration date
03/31/2007
Last updated
07/08/2007
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