Provider Demographics
NPI:1043950066
Name:TRAPPS, ANTOINE
Entity Type:Individual
Prefix:
First Name:ANTOINE
Middle Name:
Last Name:TRAPPS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 S EUCLID AVE # 4A
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-3901
Mailing Address - Country:US
Mailing Address - Phone:773-430-6658
Mailing Address - Fax:
Practice Address - Street 1:431 S EUCLID AVE # 4A
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-3901
Practice Address - Country:US
Practice Address - Phone:773-430-6658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician