Provider Demographics
NPI:1689232720
Name:CAZALES, ROSE (BSW)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:
Last Name:CAZALES
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3843 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-4623
Mailing Address - Country:US
Mailing Address - Phone:773-884-2215
Mailing Address - Fax:
Practice Address - Street 1:3843 W 63RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-4623
Practice Address - Country:US
Practice Address - Phone:773-884-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker