Healthcare Provider Details

I. General information

NPI: 1831850239
Provider Name (Legal Business Name): LAURA HAMILTON BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 N CATHERINE AVE
LA GRANGE IL
60525-5930
US

IV. Provider business mailing address

1511 E 57TH ST APT 3
CHICAGO IL
60637-7165
US

V. Phone/Fax

Practice location:
  • Phone: 765-465-5681
  • Fax:
Mailing address:
  • Phone: 765-465-5681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number152.001195
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: