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General NPI Number Information
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NPI Number | 1720303548
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Entity Type | Individual
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Provider Name | LORRAINE A DANIEL PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 10725 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643-3135
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Country | US
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Telephone | 773-405-7449
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Fax | 773-821-5257
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Provider Business Mailing Address
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Address Line | 966 E 100TH PL
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City | CHICAGO
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State | IL
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Zip | 60628-1682
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Country | US
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Telephone | 773-405-7449
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Fax | 773-821-5257
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 071005845
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071005845
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License Number State | IL
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