MICHAEL J DIDOMENICO PSYD
NPI 1417070152
Clinical Neuropsychologist in Wilmette, IL

Q: What is Michael J Didomenico Psyd's NPI number?

The NPI number for Michael J Didomenico Psyd is 1417070152. It was assigned to this organization in the NPPES registry on April 9, 2007.

Q: What is Michael J Didomenico Psyd's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Active since April 09, 2007

3545 LAKE AVE STE 100, WILMETTE, IL 60091(844) 251-1800(847) 251-1866 Get Directions Write a Review

NPPES record last updated: September 22, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Michael J Didomenico Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL J DIDOMENICO PSYD (NPI 1417070152) is a healthcare organization registered as a clinical neuropsychologist in Wilmette, Illinois and active in the NPI registry since April 2007. The organization lists Janeen Berrios, Account Manager, as its authorized official.

NPPES Registry Identity

NPI1417070152

Entity TypeOrganization

Primary Taxonomy103G00000X

Legal Business NameMICHAEL J DIDOMENICO PSYD

Location Address3545 LAKE AVE STE 100Wilmette, IL 60091-1058

Mailing AddressPo Box 443Winnetka, IL 60093-0443 · (847) 770-6088 · Fax (847) 562-0202

Phone(844) 251-1800

Fax(847) 251-1866

Organization SubpartNo

Authorized OfficialJaneen BerriosAccount Manager · (847) 770-6088

Enumeration DateApril 9, 2007

Last NPPES UpdateSeptember 22, 2011

✔ NPI 1417070152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in IL · 071005762

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X · License 071005762 (IL)

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 071005762 (IL)

3545 LAKE AVE STE 100, Wilmette, IL 60091

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Other Identifiers 2

Medicare PIN530020IL

Medicare UPINP08393IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael J Didomenico Psyd's NPI number?

The NPI number for Michael J Didomenico Psyd is 1417070152. It was assigned to this organization in the NPPES registry on April 9, 2007.

Where is Michael J Didomenico Psyd located?

Michael J Didomenico Psyd is located at 3545 Lake Ave Ste 100, Wilmette, IL 60091. The listed phone number is (844) 251-1800.

What is Michael J Didomenico Psyd's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

When was this NPI record last updated?

The NPPES record for Michael J Didomenico Psyd was last updated on September 22, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.