Provider Demographics
NPI:1376830240
Name:ROMERO, MEGAN (MA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2663 PRAIRIE AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-5744
Mailing Address - Country:US
Mailing Address - Phone:847-400-4892
Mailing Address - Fax:
Practice Address - Street 1:2663 PRAIRIE AVE
Practice Address - Street 2:APT 3
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-5744
Practice Address - Country:US
Practice Address - Phone:847-400-4892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst