Provider Demographics
NPI:1598944530
Name:TRAKHTMAN, LAURA S (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:S
Last Name:TRAKHTMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8936 NILES CENTER RD # D
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1847
Mailing Address - Country:US
Mailing Address - Phone:773-383-2518
Mailing Address - Fax:
Practice Address - Street 1:8936 NILES CENTER RD # D
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1847
Practice Address - Country:US
Practice Address - Phone:773-383-2518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007369103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical