Provider Information for 1811191539
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ANGELA M ROIKO BOGUST LCSW
Other Names:Former Name:ANGELA M ROIKO LCSWSex: Female
NPI: 1811191539
Last Updated: 2008-03-19
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1811191539 | ||||||||
| Enumeration Date | 2007-06-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 912 S WOOD ST CHICAGO, IL 60612-4300 United States Phone: 312-996-7206 | Fax:312-996-9788 | ||||||||
| Primary Practice Address | 912 S WOOD ST CHICAGO, IL 60612-4300 United States Phone: 312-996-7206 | Fax:312-996-9788 | ||||||||
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