Provider Demographics
NPI:1770650731
Name:EPSTEIN, ROSALIE O (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROSALIE
Middle Name:O
Last Name:EPSTEIN
Suffix:
Gender:F
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 1:419 BEECH DRIVE
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3249
Mailing Address - Country:US
Mailing Address - Phone:847-657-7150
Mailing Address - Fax:847-657-0978
Practice Address - Street 1:419 BEECH DRIVE
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3249
Practice Address - Country:US
Practice Address - Phone:847-657-7150
Practice Address - Fax:847-657-0978
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01622722OtherBLUE CROSS BLUE SHIELD
IL9202612CHICOtherPRIVATE HEALTHCARE SYSTEM
IL212174Medicare ID - Type Unspecified