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NPI Code Detail

MEDICARE: LAURA KUPPERMAN-CARON PH.D.

MEDICARE: LAURA KUPPERMAN-CARON PH.D.
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
1103TC0700XClinical PsychologistPY 9118FL
2103TC0700XClinical Psychologist071.010882IL

General Provider Information

NPI Number : 1962803197
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA KUPPERMAN-CARON PH.D.
Provider Business Mailing Address
First Line : 30 N MICHIGAN AVE STE 901
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3767
Country : US
Telephone Number : 312-380-9155
Fax Number :
Provider Business Practice Location Address
First Line : 30 N MICHIGAN AVE STE 901
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3767
Country : US
Telephone Number : 312-380-9155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2014
Last Update Date : 09/18/2025

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