Individual provider Active NPI

Laura A. Bauhof, PH.D.

  • Clinical Psychologist
  • Wheaton, IL
National Provider Identifier
1376937508
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.008985 Issued in IL
Practice address
1725 S Naperville Rd
Suite 207
Wheaton, IL 60189-5805
Phone
(630) 480-7005
NPI assigned
Mar 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.008985 IL Primary
Clinical Psychologist 103TC0700X 6866 OH

Addresses

Primary practice location

1725 S Naperville Rd
Suite 207
Wheaton, IL 60189-5805

Mailing address

1725 S Naperville Rd
Suite 207
Wheaton, IL 60189-5805
Phone (630) 480-7005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430001997 IL Practitioner - Clinical Psychologist 7719327311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Loyola University of Chicago, Stritch School of Medicine, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1725 S Naperville Rd
Suite 207
Wheaton, IL 60189-5855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6866OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Timothy Madvig Clinical PastSince Apr 16, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1376937508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD",
            "address_2": "SUITE 207",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895805",
            "telephone_number": "630-480-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 S NAPERVILLE RD",
            "address_2": "SUITE 207",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895805",
            "telephone_number": "630-480-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUHOF",
        "first_name": "LAURA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008985",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6866",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.