Provider Demographics
NPI:1437823572
Name:DIANA M. ROTHERMEL, PSY.D., PLLC
Entity Type:Organization
Organization Name:DIANA M. ROTHERMEL, PSY.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROTHERMEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-773-1774
Mailing Address - Street 1:3601 ALGONQUIN RD STE 335
Mailing Address - Street 2:
Mailing Address - City:ROLLING MEADOWS
Mailing Address - State:IL
Mailing Address - Zip Code:60008-3107
Mailing Address - Country:US
Mailing Address - Phone:847-773-1774
Mailing Address - Fax:
Practice Address - Street 1:3601 ALGONQUIN RD STE 335
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-3107
Practice Address - Country:US
Practice Address - Phone:847-773-1774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty