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NPI Code Detail

MEDICARE: COURTNEY ROMBA MD

MEDICARE:   COURTNEY  ROMBA  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician125.061591IL
22084P0804XChild & Adolescent Psychiatry Physician036137668IL

General Provider Information

NPI Number : 1255696290
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY ROMBA MD
Provider Business Mailing Address
First Line : 1747 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1264
Country : US
Telephone Number : 312-996-2200
Fax Number :
Provider Business Practice Location Address
First Line : 1747 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1264
Country : US
Telephone Number : 312-996-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2012
Last Update Date : 03/19/2026

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