NPI Code Detail JSON Logo

1104342476 NPI number — LARA ELISABETH VAN BEEK ED.S.

NPI Number: 1104342476
Health Care Provider/Practitioner: LARA ELISABETH VAN BEEK ED.S.

Information about “1104342476” NPI (LARA ELISABETH VAN BEEK ED.S.) exists in 1104342476 in HTML format HTML  |  1104342476 in plain Text format TXT  |  1104342476 in PDF (Portable Document Format) PDF  |  1104342476 in an XML format XML  formats.

NPI Number : 1104342476 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104342476",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "VAN BEEK",
    "FirstName": "LARA",
    "MiddleName": "ELISABETH",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "ED.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KUBILIUS",
    "OtherFirstName": "LARA",
    "OtherMiddleName": "ELISABETH",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "ED. S.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3450 OAKTON ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SKOKIE",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60076-2951",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "847-679-9797",
    "MailingAddressFaxNumber": "847-679-1126",
    "FirstLinePracticeLocationAddress": "500 KING ARTHUR WAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOLINGBROOK",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60440",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "630-739-3603",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/18/2017",
    "LastUpdateDate": "09/11/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103TS0200X",
        "TaxonomyName": "School Psychologist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.