Provider Demographics
NPI:1114137866
Name:ROZENFELD, ELLEN JUDITH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:JUDITH
Last Name:ROZENFELD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 N HALSTED ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4371
Mailing Address - Country:US
Mailing Address - Phone:312-943-4003
Mailing Address - Fax:312-943-4003
Practice Address - Street 1:2041 N HALSTED ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4371
Practice Address - Country:US
Practice Address - Phone:312-943-4003
Practice Address - Fax:312-943-4003
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist