Organization
IDS GROUP ROSELLE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID C IDERAN LCPC (PRESIDENT)
(847) 668-8969
Entity
Organization
Contact information
Practice address
644 E IRVING PARK RD, ROSELLE, IL 60172-2303
(847) 668-8969
(630) 893-8477
Mailing address
644 E IRVING PARK RD, ROSELLE, IL 60172-2303
(847) 668-8969
(630) 893-8477
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
31870006
IL
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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