Provider Demographics
NPI:1417127879
Name:EYMAN, LORI (MA)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:
Last Name:EYMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E 22ND ST STE 210
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6108
Mailing Address - Country:US
Mailing Address - Phone:630-627-5000
Mailing Address - Fax:630-627-5032
Practice Address - Street 1:10 E 22ND ST STE 210
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6108
Practice Address - Country:US
Practice Address - Phone:630-627-5000
Practice Address - Fax:630-627-5032
Is Sole Proprietor?:No
Enumeration Date:2008-03-01
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.0005617101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional