Provider Demographics
NPI:1689897639
Name:MORJAL, DANIEL G (PSYD, MSCP)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:MORJAL
Suffix:
Gender:
Credentials:PSYD, MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W DUNDEE RD UNIT 1002
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-1235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4809 N RAVENSWOOD AVE UNIT 320
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-4417
Practice Address - Country:US
Practice Address - Phone:773-800-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL374-000010103TP0016X
IL074-000010103TP0016X
IL071-007153103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical