Boldt, Roseanne Marie

Boldt, Roseanne Marie is an individual health care provider with primary practice located at 211 Robert Parker Coffin Rd , Long Grove IL 60047. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Boldt, Roseanne Marie can be contacted via phone (847) 821-1459.

Contact Information

Primary practice address
211 Robert Parker Coffin Rd Long Grove IL 60047
Phone: (847) 821-1459
Fax: (847) 359-7673
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X Illinois

Profile Details

NPI number 1922109156
LBN Legal business name Boldt, Roseanne Marie
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922109156 NPPES
Illinois Other 0004907383 BCBS

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