Provider Demographics
NPI:1356809586
Name:ROSEMARY MAGANA LLC
Entity type:Organization
Organization Name:ROSEMARY MAGANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGANA
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-369-7679
Mailing Address - Street 1:833 W 15TH PL UNIT 602
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-1844
Mailing Address - Country:US
Mailing Address - Phone:708-369-7679
Mailing Address - Fax:
Practice Address - Street 1:1200 W 35TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609-1305
Practice Address - Country:US
Practice Address - Phone:708-369-7679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty