Provider Demographics
NPI:1265164073
Name:LAURETTE FERRARESI, PH.D.
Entity type:Organization
Organization Name:LAURETTE FERRARESI, PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARESI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-307-8367
Mailing Address - Street 1:284 CHARAL LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5102
Mailing Address - Country:US
Mailing Address - Phone:312-307-8367
Mailing Address - Fax:
Practice Address - Street 1:100 VILLAGE GRN STE 220
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-3095
Practice Address - Country:US
Practice Address - Phone:312-307-8367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)