Provider Demographics
NPI:1104857739
Name:HONOR, LAURIE FELDMAN (PHD)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:FELDMAN
Last Name:HONOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 DUNDEE RD
Mailing Address - Street 2:SUITE 1302
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2727
Mailing Address - Country:US
Mailing Address - Phone:773-665-6507
Mailing Address - Fax:
Practice Address - Street 1:666 DUNDEE RD
Practice Address - Street 2:SUITE 1302
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2727
Practice Address - Country:US
Practice Address - Phone:773-665-6507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X, 103TF0000X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01673636OtherBLUE CROSS BLUE SHIELD
IL01673636OtherBLUE CROSS BLUE SHIELD
ILR18993Medicare UPIN