Provider Demographics
NPI:1730615808
Name:ROSATI, ALESSA
Entity type:Individual
Prefix:
First Name:ALESSA
Middle Name:
Last Name:ROSATI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21925 W FIELD PKWY STE 215
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60010-7278
Mailing Address - Country:US
Mailing Address - Phone:847-438-4222
Mailing Address - Fax:
Practice Address - Street 1:850 BRISTOL DR
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-4507
Practice Address - Country:US
Practice Address - Phone:847-977-7608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208.000578106H00000X
IL166.001485106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist