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General NPI Number Information
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NPI Number | 1053514364
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Entity Type | Individual
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Provider Name | LAURA E LAMBERT PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 122 S MICHIGAN AVE STE 1468
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City | CHICAGO
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State | IL
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Zip | 60603-6155
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Country | US
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Telephone | 773-642-5006
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Fax |
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Provider Business Mailing Address
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Address Line | 5490 S SOUTH SHORE DRIVE 4N
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City | CHICAGO
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State | IL
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Zip | 60615-5981
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Country | US
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Telephone | 773-667-1063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.007179
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License Number State | IL
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