Roger Hartline, LCSW | |
272 S Prairie Ave, Bradley, IL 60915-2038 | |
(815) 944-2501 | |
Not Available |
Full Name | Roger Hartline |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 272 S Prairie Ave, Bradley, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821705229 | NPI | - | NPPES |
149.026971 | Other | IL | STATE OF ILLINOIS |
149.026971 | Other | IL | LICENSED CLINICAL SOCIAL WORKER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 149.026971 (Illinois) | Primary |
Entity Name | Riverside Health System |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417061193 PECOS PAC ID: 3274434717 Enrollment ID: O20040116000780 |
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220414000139 |
Mailing Address | Practice Location Address |
---|---|
Roger Hartline, LCSW 272 S Prairie Ave, Bradley, IL 60915-2038 Ph: (815) 944-2501 | Roger Hartline, LCSW 272 S Prairie Ave, Bradley, IL 60915-2038 Ph: (815) 944-2501 |
Mrs. Debra Marie Tamez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 525 E North St Ste B, Bradley, IL 60915 Phone: 815-933-0667 Fax: 815-933-0665 | |
Miss Elizabeth Rieger, MS. LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 525 E North St, Ste B, Bradley, IL 60915 Phone: 815-933-0667 Fax: 815-933-0665 | |
Kayla Lynn Button, MSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 300 N Kennedy Dr Ste 8, Bradley, IL 60915 Phone: 586-924-6802 | |
Justin Gunderson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 300 N Kennedy Dr, Suite 8, Bradley, IL 60915 Phone: 815-929-2009 Fax: 815-929-1284 | |
Kathleen Mary Connelly, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 265 Stebbings Ct Ste 1, Bradley, IL 60915 Phone: 815-944-2753 | |
Mrs. Paula Renee Dykstra, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 555 E North St, Suite D, Bradley, IL 60915 Phone: 815-935-8133 |