Healthcare Provider Details

I. General information

NPI: 1184778748
Provider Name (Legal Business Name): JOHN FRANKLIN BELTRAMO PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 EVERTS PL
HIGHWOOD IL
60040-1717
US

IV. Provider business mailing address

243 EVERTS PL
HIGHWOOD IL
60040-1717
US

V. Phone/Fax

Practice location:
  • Phone: 847-571-4105
  • Fax:
Mailing address:
  • Phone: 847-571-4105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071007099
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: