Provider Demographics
NPI:1134620800
Name:ROMANICK, DANIELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:ROMANICK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 WAUKEGAN RD # 2R
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2124
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13901 S LYDIA AVE
Practice Address - Street 2:
Practice Address - City:ROBBINS
Practice Address - State:IL
Practice Address - Zip Code:60472-2215
Practice Address - Country:US
Practice Address - Phone:708-385-5642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist