1588744551 NPI number — DR. JODI NORDMANN HARAP PHD

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 1588744551 NPI number — DR. JODI NORDMANN HARAP PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARAP
Provider First Name:
JODI
Provider Middle Name:
NORDMANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
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:
1588744551
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1701 E. WOODFIELD ROAD
Provider Second Line Business Mailing Address:
SUITE 1000
Provider Business Mailing Address City Name:
SCHAUMBURG
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60173-5113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-240-2211
Provider Business Mailing Address Fax Number:
847-240-2418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1101 31ST ST STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOWNERS GROVE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60515-5535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-206-0272
Provider Business Practice Location Address Fax Number:
630-598-9123
Provider Enumeration Date:
10/16/2006

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: 103TC0700X , with the licence number:  071-006188 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 46-5304932 . This is a "ALDER TAX ID NO" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 071006188 . This is a "IL STATE LICENSE NO" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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