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1702 Sherman Ave Evanston IL 60201-3713 | |
| (847) 425-9708 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1702 Sherman Ave, Evanston, Illinois |
| Authorized Official Name and Position | Marni Bertha Rosen (PRACTICE MANAGER) |
| Authorized Official Contact | 8474488336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1702 Sherman Ave Evanston IL 60201-3713 Ph: (847) 425-9708 | 1702 Sherman Ave Evanston IL 60201-3713 Ph: (847) 425-9708 |
| NPI Number | 1558606590 |
|---|---|
| Provider Enumeration Date | 12/03/2012 |
| Last Update Date | 05/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558606590 | NPI | - | NPPES |
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