Provider Demographics
NPI:1093045643
Name:LAPUMA, ERIN KELLEY
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:KELLEY
Last Name:LAPUMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6235
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-6235
Mailing Address - Country:US
Mailing Address - Phone:847-630-4714
Mailing Address - Fax:
Practice Address - Street 1:518 DEERPATH DR
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-9031
Practice Address - Country:US
Practice Address - Phone:847-630-4714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL12030904171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter