Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL J DI DOMENICO, PSYD
Active Sole ProprietorMICHAEL J DI DOMENICO, PSYD is a Clinical Neuropsychologist healthcare provider located in NORTHBROOK, Illinois. NPI 1861442345 is currently active in the NPPES registry. Verify at CMS.
Clinical Neuropsychologist · NORTHBROOK, IL
Registration Details
- NPI Number
- 1861442345
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 12, 2006 (20.281554868023 yrs)
- Last Updated
- Jul 25, 2022
- Licenses
-
071055762 (IL)071005762 (IL)071005762 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
707 SKOKIE BLVD STE 600NORTHBROOK, IL, 600622841Browse IL providers · Browse ZIP 60062
- Phone
- 6306320746
- Fax
- 8472728221
- Primary Specialty
-
Clinical Neuropsychologist
103G00000X
- Additional Specialty
- Clinical Psychologist
- Additional Specialty
- Clinical Neuropsychologist
Other Clinical Neuropsychologist Providers in NORTHBROOK, IL
| Name | Credential | NPI |
|---|---|---|
| DR. JOHN BARTOK | PH.D. | 1639215460 |
| KATHLEEN MARIE NUGENT | PH.D. | 1578890018 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.