Provider Demographics
NPI:1659821544
Name:ROSALIND FRANKLIN UNIVERSITY OF MEDICINE & SCIENCE
Entity Type:Organization
Organization Name:ROSALIND FRANKLIN UNIVERSITY OF MEDICINE & SCIENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEAN, COLLEGE OF HEALTH PROFESSIONS
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,
Authorized Official - Phone:847-578-8464
Mailing Address - Street 1:3333 GREEN BAY RD
Mailing Address - Street 2:ROSALIND FRANKLIN UNIVERSITY
Mailing Address - City:NORTH CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064-3037
Mailing Address - Country:US
Mailing Address - Phone:847-578-3311
Mailing Address - Fax:
Practice Address - Street 1:3471 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3090
Practice Address - Country:US
Practice Address - Phone:847-578-8723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009327103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty