Healthcare Provider Details

I. General information

NPI: 1043114879
Provider Name (Legal Business Name): JOHANNA MACARIOLA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 N LARCH AVE
ELMHURST IL
60126-2312
US

IV. Provider business mailing address

304 N LARCH AVE
ELMHURST IL
60126-2312
US

V. Phone/Fax

Practice location:
  • Phone: 224-622-3965
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHANNA MACARIOLA
Title or Position: OWNER/PSYCHOLOGIST
Credential:
Phone: 224-622-3965