Provider Demographics
NPI:1043388655
Name:ROMPALA, VIKKI LYNN
Entity type:Individual
Prefix:
First Name:VIKKI
Middle Name:LYNN
Last Name:ROMPALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VIKKI
Other - Middle Name:LYNN
Other - Last Name:ROMPALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:5059 N WINCHESTER AVE
Mailing Address - Street 2:#2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2691
Mailing Address - Country:US
Mailing Address - Phone:773-728-3365
Mailing Address - Fax:
Practice Address - Street 1:8949 S STONY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-2817
Practice Address - Country:US
Practice Address - Phone:773-374-3748
Practice Address - Fax:773-374-6223
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical