Provider Demographics
NPI:1194310920
Name:JURAN, BETHANY I
Entity type:Individual
Prefix:MISS
First Name:BETHANY
Middle Name:
Last Name:JURAN
Suffix:I
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:BETHANY
Other - Middle Name:
Other - Last Name:JURAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:357 N MACARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-3884
Mailing Address - Country:US
Mailing Address - Phone:847-894-5932
Mailing Address - Fax:
Practice Address - Street 1:111 BARCLAY BLVD STE 318
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-3623
Practice Address - Country:US
Practice Address - Phone:847-748-2019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178013846101YP2500X
IL180.014724101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional