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General NPI Number Information
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NPI Number | 1851865299
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Entity Type | Individual
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Provider Name | NICOLAS COMEAU PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 1335 N MILL ST
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City | NAPERVILLE
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State | IL
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Zip | 60563-2261
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Country | US
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Telephone | 630-646-8068
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Fax | 630-646-5479
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Provider Business Mailing Address
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Address Line | 122 STURTZ ST
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City | BARRINGTON
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State | IL
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Zip | 60010-4432
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Country | US
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Telephone | 847-721-4625
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.009947
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License Number State | IL
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