Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | IL | |
N | 103TC0700X | Clinical Psychologist | IL | |
N | 103TF0000X | Family Psychologist | IL | |
N | 103TH0100X | Health Service | IL |
NPI | 1104857739 |
---|---|
Provider Name | Laurie Feldman Honor |
First Address | Northbrook, IL 60062-2727 |
Second Address | Northbrook, IL 60062-2727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01673636 | BLUE CROSS BLUE SHIELD (01) | IL |
R18993 | (02) | IL |