Provider Demographics
NPI:1508624479
Name:ROSENBLUM, JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:ROSENBLUM
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 1:1336 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-2316
Mailing Address - Country:US
Mailing Address - Phone:847-987-0996
Mailing Address - Fax:
Practice Address - Street 1:1336 OXFORD RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-2316
Practice Address - Country:US
Practice Address - Phone:847-987-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1122691041C0700X
IL149-0075761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical