Provider Demographics
NPI:1053873810
Name:ROHLEDER, JOHN (MENTAL HEALTH COUNSE)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:ROHLEDER
Suffix:
Gender:M
Credentials:MENTAL HEALTH COUNSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 S HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4417
Mailing Address - Country:US
Mailing Address - Phone:630-222-4780
Mailing Address - Fax:
Practice Address - Street 1:244 S HICKORY AVE
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4417
Practice Address - Country:US
Practice Address - Phone:630-222-4780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.014645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health