Provider Demographics
NPI:1770526600
Name:(MUNDT) ROMANO, KAREN LYNN (DEVELOPMENTAL THERAP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:(MUNDT) ROMANO
Suffix:
Gender:F
Credentials:DEVELOPMENTAL THERAP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LYNN
Other - Last Name:MUNDT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DEVELOPMENTAL THERAP
Mailing Address - Street 1:799 S MCLEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-6704
Mailing Address - Country:US
Mailing Address - Phone:847-488-9207
Mailing Address - Fax:847-488-9209
Practice Address - Street 1:799 S MCLEAN BLVD
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-6704
Practice Address - Country:US
Practice Address - Phone:847-488-9207
Practice Address - Fax:847-488-9209
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist