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Individual

SHERRY A ROSKAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LMFT

Contact information

Practice address
773 W LINCOLN BLVD, SUITE 101, FREEPORT, IL 61032-4976
(815) 990-8210
(815) 801-4674
Mailing address
773 W LINCOLN BLVD, SUITE 101, FREEPORT, IL 61032-6780
(815) 990-8210
(815) 801-4674

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166000462
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05821971
BCBS
01
08932004
BCBSIL
IL
Enumeration date
11/06/2006
Last updated
11/04/2010
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