Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Supatchara Laksanaprom, PSYD

Individual provider Clinical Psychologist · NPI 1477198000

Dr. Supatchara Laksanaprom, PSYD is a Clinical Psychologist in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2019.

Licensed in
IL
In the registry since
2019
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

6323 N Avondale Ave Ste 108
Chicago, IL 60631-1958
Phone: (312) 975-3307
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 071010079 (IL)

Record details

NPI number1477198000
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorNo
NPI enumeratedNovember 6, 2019
Last updated in NPPESNovember 6, 2019

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