| Rooted Therapeutics | |
|
3058 W Belmont Ave # 2d Chicago IL 60618-5707 | |
| (312) 725-4879 | |
| Not Available |
| Full Name | Rooted Therapeutics |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3058 W Belmont Ave # 2d, Chicago, Illinois |
| Authorized Official Name and Position | Diandra Entler (DIRECTOR) |
| Authorized Official Contact | 3127254879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rooted Therapeutics 1628 W Ohio St Apt 2f Chicago IL 60622-6038 Ph: (127) 254-8793 | Rooted Therapeutics 3058 W Belmont Ave # 2d Chicago IL 60618-5707 Ph: (312) 725-4879 |
| NPI Number | 1124765896 |
|---|---|
| Provider Enumeration Date | 05/16/2022 |
| Last Update Date | 02/03/2023 |
| Certification Date | 02/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124765896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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