Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL J DIDOMENICO PSYD
Active OrganizationMICHAEL J DIDOMENICO PSYD is a Clinical Neuropsychologist organization located in WILMETTE, Illinois. NPI 1417070152 is currently active in the NPPES registry. Verify at CMS.
Clinical Neuropsychologist · WILMETTE, IL
Registration Details
- NPI Number
- 1417070152
- Provider Type
- Organization
- NPI Issued
- Apr 9, 2007 (19.163785257163 yrs)
- Last Updated
- Sep 22, 2011
- Licenses
-
071005762 (IL)071005762 (IL)071005762 (IL)
Practice Information
- Address
-
3545 LAKE AVE STE 100WILMETTE, IL, 600911058Browse IL providers · Browse ZIP 60091
- Phone
- 8442511800
- Fax
- 8472511866
- Primary Specialty
-
Clinical Neuropsychologist
103G00000X
- Additional Specialty
- Clinical Psychologist
- Additional Specialty
- Clinical Neuropsychologist
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.