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Individual

ROSA CISNEROS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
4058 W 63RD ST, CHICAGO, IL 60629-4639
(773) 584-6200
Mailing address
1940 S WESTERN AVE STE 205, CHICAGO, IL 60608-2503
(773) 584-6200

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.108637
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
150108637
LSW
IL
Enumeration date
01/09/2026
Last updated
01/09/2026
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