Individual
DANIELLE KOMEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 296-5930
(773) 296-5920
Mailing address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149012483
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093787095
—
MA
Enumeration date
08/19/2008
Last updated
08/01/2011
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