Provider Demographics
NPI:1205025111
Name:KESSLER, ROSE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSE
Middle Name:
Last Name:KESSLER
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 1:4S 100 ROUTE 59
Mailing Address - Street 2:UNIT 6
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563
Mailing Address - Country:US
Mailing Address - Phone:630-416-8289
Mailing Address - Fax:630-416-8306
Practice Address - Street 1:4S 100 ROUTE 59
Practice Address - Street 2:UNIT 6
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563
Practice Address - Country:US
Practice Address - Phone:630-416-8289
Practice Address - Fax:630-416-8306
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK11886Medicare UPIN