Provider Demographics
NPI:1942576004
Name:RODOLFF, AIMEE (PSYD, LCP, APIT)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:
Last Name:RODOLFF
Suffix:
Gender:F
Credentials:PSYD, LCP, APIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 S MILWAUKEE AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3786
Mailing Address - Country:US
Mailing Address - Phone:847-220-8010
Mailing Address - Fax:
Practice Address - Street 1:1590 S MILWAUKEE AVE STE 301
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3786
Practice Address - Country:US
Practice Address - Phone:847-220-8010
Practice Address - Fax:847-220-5918
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009403103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty