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Individual

DR. STEPHAN ROMM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
636 CHURCH ST, SUITE419A, EVANSTON, IL 60201-4508
(847) 328-3350
Mailing address
2353 RIDGE AVE, EVANSTON, IL 60201-2662
(847) 328-3350
(847) 491-6287

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-004931
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
216-06218
BCBS ID #
IL
01
232373643
UNITED BEHAVIORAL HEALTH
IL
01
273939000
MAGELLAN
IL
01
782-5241
AETNA
IL
Enumeration date
05/05/2006
Last updated
06/01/2009
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