Provider Demographics
NPI:1851865299
Name:COMEAU, NICOLAS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NICOLAS
Middle Name:
Last Name:COMEAU
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 STURTZ ST
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-4432
Mailing Address - Country:US
Mailing Address - Phone:847-721-4625
Mailing Address - Fax:
Practice Address - Street 1:1335 N MILL ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2261
Practice Address - Country:US
Practice Address - Phone:630-646-8068
Practice Address - Fax:630-646-5479
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009947103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical