Provider Demographics
NPI:1033545405
Name:DESSAU, ROSE (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:DESSAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 N DEARBORN ST
Mailing Address - Street 2:UNIT 9A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-8218
Mailing Address - Country:US
Mailing Address - Phone:312-643-5183
Mailing Address - Fax:312-643-5183
Practice Address - Street 1:1250 N DEARBORN ST
Practice Address - Street 2:UNIT 9A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-8218
Practice Address - Country:US
Practice Address - Phone:312-643-5183
Practice Address - Fax:312-643-5183
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490060741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical