Organization
ROSECRANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VICK (CFO)
(815) 387-5642
Entity
Organization
Contact information
Practice address
700 S GREGORY ST STE A, URBANA, IL 61801-3622
(815) 391-1000
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3874
(815) 387-5623
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
133V00000X
Registered Dietitian
—
—
Other
Enumeration date
05/12/2025
Last updated
05/12/2025
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