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General NPI Number Information
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NPI Number | 1265504237
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Entity Type | Individual
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Provider Name | AUDRA KAPLAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 540 W FRONTAGE RD SUITE 2255
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City | NORTHFIELD
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State | IL
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Zip | 60093-1250
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Country | US
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Telephone | 847-501-2851
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 FOREST AVE
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-3414
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Country | US
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Telephone | 847-266-7136
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Fax | 847-266-7139
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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 |
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License Number State | IL
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