Provider Demographics
NPI:1881172252
Name:ROMO, CHRISTINA (LCSW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:ROMO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6124 S MASSASOIT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-4516
Mailing Address - Country:US
Mailing Address - Phone:312-890-5908
Mailing Address - Fax:
Practice Address - Street 1:1837 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-4303
Practice Address - Country:US
Practice Address - Phone:773-847-6465
Practice Address - Fax:888-542-8200
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-29
Last Update Date:2018-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0171211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical