Active NPI
Rose Ann Quaresima, LCSW
- Social Worker
- Dekalb, IL
National Provider Identifier
1508931858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 835 South Fourth Street
Dekalb, IL 60115 - Phone
- (815) 787-2566
- Fax
- (815) 758-1430
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | IL | Primary |
Addresses
Primary practice location
835 South Fourth Street
Dekalb, IL 60115
Mailing address
835 South Fourth Street
Dekalb, IL 60115
Phone (815) 787-2566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01923314 | Other | BLUE CROSS & BLUE SHIELD |
Other names 1
- Mrs. Rose Ann Quaresima Patrick
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508931858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 SOUTH FOURTH STREET",
"city": "DEKALB",
"state": "IL",
"postal_code": "60115",
"telephone_number": "815-787-2566",
"fax_number": "815-758-1430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 SOUTH FOURTH STREET",
"city": "DEKALB",
"state": "IL",
"postal_code": "60115",
"telephone_number": "815-787-2566",
"fax_number": "815-758-1430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUARESIMA",
"first_name": "ROSE",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "01923314",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ROSE",
"last_name": "QUARESIMA PATRICK",
"middle_name": "ANN",
"prefix": "MRS.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Dekalb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.