| Tatiana Rohner Llc | |
|
3411 W Diversey Ave Ste 14 Chicago IL 60647-1245 | |
| (312) 608-5042 | |
| Not Available |
| Full Name | Tatiana Rohner Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3411 W Diversey Ave Ste 14, Chicago, Illinois |
| Authorized Official Name and Position | Tatiana Rohner (OWNER) |
| Authorized Official Contact | 3126085042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tatiana Rohner Llc 329 Chestnut Ln Oak Park IL 60302-4402 Ph: (312) 608-5042 | Tatiana Rohner Llc 3411 W Diversey Ave Ste 14 Chicago IL 60647-1245 Ph: (312) 608-5042 |
| NPI Number | 1568120632 |
|---|---|
| Provider Enumeration Date | 12/06/2021 |
| Last Update Date | 03/09/2022 |
| Certification Date | 03/09/2022 |
| Medicare PECOS PAC ID | 7315332475 |
|---|---|
| Medicare Enrollment ID | O20220328001516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568120632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Tatiana Rohner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538709225 PECOS PAC ID: 8224423389 Enrollment ID: I20220328001590 |
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