Provider Demographics
NPI:1457475386
Name:JONES, LAURA STAHL (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:STAHL
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:DORCAS
Other - Last Name:STAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:913 LOIS LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-1927
Mailing Address - Country:US
Mailing Address - Phone:847-657-9525
Mailing Address - Fax:847-657-9526
Practice Address - Street 1:4711 GOLF RD STE 1200
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1200
Practice Address - Country:US
Practice Address - Phone:847-874-7124
Practice Address - Fax:847-657-9526
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0853322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL318881Medicare ID - Type Unspecified
ILF47248Medicare UPIN