Provider Demographics
NPI:1053514364
Name:LAMBERT, LAURA E (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:E
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5490 S SOUTH SHORE DRIVE 4N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-5981
Mailing Address - Country:US
Mailing Address - Phone:773-667-1063
Mailing Address - Fax:
Practice Address - Street 1:122 S MICHIGAN AVE STE 1468
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6155
Practice Address - Country:US
Practice Address - Phone:773-642-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007179103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0009677974OtherAETNA