1487698577 NPI number — MRS. NICOLE LAUFER STEINBERG DPT

Table of Contents

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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