Provider Demographics
NPI:1215310107
Name:MARKOYA, LAURA (LSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MARKOYA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 OLD GLENVIEW RD
Mailing Address - Street 2:STE. 15
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2963
Mailing Address - Country:US
Mailing Address - Phone:847-256-2000
Mailing Address - Fax:
Practice Address - Street 1:3330 OLD GLENVIEW RD
Practice Address - Street 2:STE. 15
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2963
Practice Address - Country:US
Practice Address - Phone:847-256-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.015727104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker