Provider Demographics
NPI:1518015353
Name:ROTHSCHILD, RONALD STEVEN (MSW,LCSW)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:STEVEN
Last Name:ROTHSCHILD
Suffix:
Gender:M
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 S BUSEY AVE
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-4028
Mailing Address - Country:US
Mailing Address - Phone:217-367-3080
Mailing Address - Fax:217-328-6765
Practice Address - Street 1:301 W GREEN ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-3200
Practice Address - Country:US
Practice Address - Phone:217-384-7922
Practice Address - Fax:217-328-6765
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
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
IL213561Medicare ID - Type Unspecified