Provider Demographics
NPI:1598489809
Name:ROSS, OLIMPIA JARET (BACHELORS)
Entity Type:Individual
Prefix:
First Name:OLIMPIA
Middle Name:JARET
Last Name:ROSS
Suffix:
Gender:F
Credentials:BACHELORS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N WOLF RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-2922
Mailing Address - Country:US
Mailing Address - Phone:847-353-1500
Mailing Address - Fax:
Practice Address - Street 1:210 N WOLF RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-2922
Practice Address - Country:US
Practice Address - Phone:847-353-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor