| Doctor Name: | DAVIDA ROSENBLOOM |
| NPI Number: | 1326263237 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | |
| Business Practice Address: | 19740 Governors Hwy Suite 117 Flossmoor, IL - 604222084 |
| Business Phone Number: | 8662965262 |
| Business Fax Number: | 7089579588 |
| Mailing Address: | 20 N Clark St, Suite 2650 CHICAGO |
| State: | IL |
| Postal Code: | 606024109 |
| Phone Number: | 8662965262 |
| Fax Number: | 3125581570 |
| NPI Enumeration Date: | 04/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |