1487698577 NPI number — MRS. NICOLE LAUFER STEINBERG DPT

Table of content: WALTER E MEYER III MD (NPI 1629067996)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487698577 NPI number — MRS. NICOLE LAUFER STEINBERG DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEINBERG
Provider First Name:
NICOLE
Provider Middle Name:
LAUFER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487698577
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
850 S WABASH AVE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60605-2113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-646-1000
Provider Business Mailing Address Fax Number:
312-224-2537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 S WABASH AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60605-2113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-646-1000
Provider Business Practice Location Address Fax Number:
312-224-2537
Provider Enumeration Date:
06/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  070015766 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 0258251 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 209881 . This is a "BAL. CTR MEDIC. GROUP NO." identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 236963283001 . This is a "BA. CTR OF IL. MEDICAID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 363396874 . This is a "TAX ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 01634372 . This is a "BAL. CTR OF IL BCBS NO." identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 200573902 . This is a "BALANCE CTR OF IL. TAX ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 210877 . This is a "MEDICARE GROUP NO," identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 1618443 . This is a "BCBS GROUP NO" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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