MEDICARE: HOWARD GARY KAPLAN PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor		CA
2	103TC0700X	Clinical Psychologist	25749	CA
3	106H00000X	Marriage & Family Therapist	34847	CA
4	103TC0700X	Clinical Psychologist	0710010593	IL

General Provider Information

NPI Number	:	1306973458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD GARY KAPLAN PHD

Provider Business Mailing Address
First Line	:	5415 N SHERIDAN RD APT 3108
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-1944
Country	:	US
Telephone Number	:	949-230-2189
Fax Number	:	949-947-9380

Provider Business Practice Location Address
First Line	:	5415 N SHERIDAN RD APT 3108
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-1944
Country	:	US
Telephone Number	:	949-230-2189
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	04/08/2022

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