Provider Demographics
NPI:1275019952
Name:ROVERUD, SOLVEIG (LCSW)
Entity Type:Individual
Prefix:
First Name:SOLVEIG
Middle Name:
Last Name:ROVERUD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:K SOLVEIG
Other - Middle Name:
Other - Last Name:ROVERUD ROSCHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:5447 N WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1304
Mailing Address - Country:US
Mailing Address - Phone:773-671-5727
Mailing Address - Fax:
Practice Address - Street 1:5138 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2828
Practice Address - Country:US
Practice Address - Phone:773-671-5727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0062551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical