Theresa A Larson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209.029761 Issued in IL

Practice address

440 Lake Cook Rd Ste 2
Deerfield, IL 60015-5263

Phone

(847) 236-9310

Fax

(847) 236-9411

NPI assigned

May 31, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rodasi LLC

  • Mental Health Counselor
  • Hoffman Estates, IL
  • NPI 1467691790

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Midwest Institute of Neurological Discovery, LLC

  • Multi-Specialty Clinic/Center
  • Deerfield, IL
  • NPI 1881065738
  NPD (past)

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1942040472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 LAKE COOK RD STE 2",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155263",
            "telephone_number": "847-236-9310",
            "fax_number": "847-236-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 LAKE COOK RD STE 2",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155263",
            "telephone_number": "847-236-9310",
            "fax_number": "847-236-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "THERESA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.029761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfonso Lapelusa, DDS
• Emily Mary Lapinski
• Lapp Chiropractic P C
• Jeanne Marie Lapp, DC
• Carmelina Laride, RPN
• Rachel Lauber, APRN, CNP
• Lauri Bauer Grief Centers
• Connie Lay-Ngo
• Tyler Thai Dinh Le, PA-C
• Phil S. Lebovitz, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.