IndividualActive
Jill Derose, LCSW
NPI 1679932503 · Clinical Social Worker · Park Ridge, IL
Provider details
- NPI number
- 1679932503
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- License
- 149016519 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
1440 Renaissance Dr
Suite 320
Park Ridge, IL 60068-1356
Phone: (847) 759-9110
Approximate (ZIP-level) locationGet directions
Mailing address
1440 Renaissance Dr
Park Ridge, IL 60068-1356
Registry dates
- Enumerated
- 2016-02-20
- Last updated
- 2016-02-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.