Organization
RENEW YOU COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB ROSSER PSYD (MANAGING MEMBER)
(773) 236-8566
Entity
Organization
Contact information
Practice address
1209 W DIVERSEY PWKY UNIT G-2, CHICAGO, IL 60614-1201
(773) 236-8566
(773) 257-7553
Mailing address
1209 W DIVERSEY PKWY UNIT G-2, CHICAGO, IL 60614-1201
(773) 236-8566
(773) 257-7553
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
071.009553
IL
Other
Enumeration date
08/21/2017
Last updated
07/24/2024
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