DR. SUPATCHARA LAKSANAPROM (NPI# 1477198000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477198000 |
| Entity Type | Individual |
| Full Name | DR. SUPATCHARA LAKSANAPROM |
| Credential | PSYD |
| Practice Address |
6323 N Avondale Ave Ste 108 Chicago IL 60631-1958 |
| Practice Telephone | 3129753307 |
| Mailing Telephone | 3129753307 |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2019-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071010079 | IL | Behavioral Health & Social Service Providers |
| Street Address |
6323 N AVONDALE AVE STE 108 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60631-1958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427686609 | Martha Agnes Bissing | Student in an Organized Health Care Education/Training Program | Resurrection Medical Education, Karen Dwulat, 7435 W. Talcott Avenue, Chicago, IL 60631 | 2020-04-01 |
| 1497383434 | Kathryn Lee Hughes | Student in an Organized Health Care Education/Training Program | 7435 W Talcott Avenue, Medical Education, Karen Dwulat, Chicago, IL 60631 | 2020-03-27 |
| 1245723121 | Thomas Walsh | Student in an Organized Health Care Education/Training Program | Resurrection Family Medicine 7447 W Talcott Ave, Ste 182, Chicago, IL 60631 | 2018-06-14 |
| 1912411893 | Briggs Therapy Group, LLC | Social Worker | 6645 N Oliphant Ave Ste F, Chicago, IL 60631 | 2017-11-29 |
| 1013467257 | Elsa Methipara | Nurse Practitioner | 6429 N Ogallah, Chicago, IL 60631 | 2016-10-12 |
| 1477001766 | Djje Holdings LLC | Psychologist | 8609 W Bryn Mawr Ave Ste 204, Chicago, IL 60631 | 2016-09-14 |
| 1538512884 | Sprout Pediatric Dentistry | Dentist | 6036 North Northwest Highway, Chicago, IL 60631 | 2016-07-21 |
| 1417305137 | Christopher Louis Scodeller | Emergency Medicine | 7435 W. Talcott A, Presence Resurrection Medical Center, Chicago, IL 60631 | 2016-06-03 |
| 1518315464 | Corbin Barwegen | Emergency Medicine | 7435 W. Talcott Ave., Chicago, IL 60631 | 2016-06-01 |
| 1013304724 | Elliott T. Deweese | Dentist | 7447 W Talcott Ave., Suite 227, Chicago, IL 60631 | 2015-04-20 |
| Find all providers in zip 60631 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699166 | Jennifer Knuepfer, Psyd, Pllc | Psychologist | 4256 N Ravenswood Ave Ste 305, Chicago, IL 60613-1114 | 2020-11-03 |
| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1730792151 | Jenny Marie Wamsat | Psychologist | 1921 W Diversey Pkwy Apt 402, Chicago, IL 60614-9412 | 2020-08-25 |
| 1497365910 | Sara Sirota | Psychologist | 5443 N Broadway St # 2s, Chicago, IL 60640-1703 | 2020-08-10 |
| 1053920512 | Alyse Renae Bedell | Psychologist | 5841 S Maryland Ave Ste 300, Chicago, IL 60637-1443 | 2020-07-30 |
| 1699392688 | Hongying Chen | Psychologist | 720 W Sheridan Rd Apt 3s, Chicago, IL 60613-3252 | 2020-06-25 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.