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Individual

ROMEO SANTANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2100 N MAIN ST STE 304, CROWN POINT, IN 46307-1877
(574) 546-1900
Mailing address
1260 IROQUOIS AVE STE 306, NAPERVILLE, IL 60563-8549
(646) 280-5093

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071010236
IL
103TC0700X
Clinical Psychologist
20043350A
IN
103TC0700X
Clinical Psychologist
Primary
20043350B
IN
106E00000X
Assistant Behavior Analyst
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1548791650
LICENSE
IL
01
20043350A
LICENSE
IN
01
20043350B
LICENSE
IN
Enumeration date
03/21/2017
Last updated
06/11/2020
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