Individual provider Active NPI

Donald Brian Rossoff, MFT

  • Marriage & Family Therapist
  • Park Ridge, IL
National Provider Identifier
1164120465
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
208.000966 Issued in IL
Practice address
1440 Renaissance Dr Ste 320
Park Ridge, IL 60068-1471
Phone
(847) 759-9110
NPI assigned
Feb 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 208.000966 IL Primary

Addresses

Primary practice location

1440 Renaissance Dr Ste 320
Park Ridge, IL 60068-1471

Mailing address

2300 Sherman Ave Apt 4B
Evanston, IL 60201-2471
Phone (224) 330-8604

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address donrossoff@thejunipercenter.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
208.000966ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Juniper Center PC CurrentSince Feb 19, 2023 Accepting new patients

Locations

1440 Renaissance Dr
Ste 320
Park Ridge, IL 60068
Phone (847) 759-9110

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1164120465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SHERMAN AVE APT 4B",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012471",
            "telephone_number": "224-330-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR STE 320",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681471",
            "telephone_number": "847-759-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSOFF",
        "first_name": "DONALD",
        "middle_name": "BRIAN",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-02-16",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "208.000966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "donrossoff@thejunipercenter.com",
            "affiliation": "N",
            "endpointDescription": "Juniper email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1440 Renaissance Dr Ste 320",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.