ILLUMINATION PSYCHOTHERAPY, PLLC (NPI# 1013557644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013557644 |
| Entity Type | Organization |
| Organization Name | ILLUMINATION PSYCHOTHERAPY, PLLC |
| Practice Address |
7300 N Cicero Ave Ste 102a Lincolnwood IL 60712-1641 |
| Practice Telephone | 7733187304 |
| Mailing Telephone | 7733187304 |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2020-06-25 |
| Authorized Official Name | GARRETT SHOTWELL (OWNER, CEO) |
| Authorized Official Telephone | 7733187304 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5557 1/2 N Magnolia Ave Apt 3e, Chicago, IL 606401334 | 7733187304 |
| Street Address |
7300 N CICERO AVE STE 102A |
| City | LINCOLNWOOD |
| State | IL |
| Zip Code | 60712-1641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275074262 | Garrett Shotwell | Social Worker | 7300 N Cicero Ave Ste 102a, Lincolnwood, IL 60712-1641 | 2017-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255998811 | Better Residential Care | Adult Companion | 7301 N. Lincoln Avenue, Suite 104, Lincolnwood, IL 60712 | 2019-05-20 |
| 1538652441 | Elysium Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 7366 N Lincoln Ave Ste 304, Lincolnwood, IL 60712 | 2018-06-14 |
| 1851805253 | Jasmine Lukose | Nurse Practitioner | 6501 N. Lincoln Ave, Lincolnwood, IL 60712 | 2017-11-21 |
| 1982134425 | Sana Baig | Dentist | 4368 W Touhy Ave, Lincolnwood, IL 60712 | 2017-06-18 |
| 1447640081 | Soghra Sorouri | Dentist | 6838 N. Kilpatrick Ave, Lincolwood, IL 60712 | 2015-02-04 |
| 1164839239 | Sunrise Nursing & Rehabilitation Center | Skilled Nursing Facility | 7383 N Lincon Ave, Suite 100, Lincolnwood, IL 60712 | 2014-07-21 |
| 1013328079 | Lawrence S. Reiner | Dentist | 4751 W. Touhy Ave, Lincolnwood, IL 60712 | 2014-05-13 |
| 1437430121 | Susan B Sorisho | Pharmacist | 7318 N East Prairie Rd, Lincolnwood, IL 60712 | 2011-09-08 |
| 1922338623 | Dean Medical, Sc | Internal Medicine | 6501 N. Sauganash, Lincolnwood, IL 60712 | 2010-01-04 |
| 1134456064 | Leah Brennan | Marriage & Family Therapist | 6834 N. Lowell Ave., Lincolnwood, IL 60712 | 2009-11-13 |
| Find all providers in zip 60712 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275074262 | Garrett Shotwell | Social Worker | 7300 N Cicero Ave Ste 102a, Lincolnwood, IL 60712-1641 | 2017-03-10 |
| 1740731355 | Christina Hoffstrom | Social Worker | 4433 W Touhy Ave # 335, Lincolnwood, IL 60712-1820 | 2016-10-18 |
| 1013329408 | Edward Meyer | Social Worker | 4433 W Touhy Ave Ste 206, Lincolnwood, IL 60712-1833 | 2014-05-20 |
| 1568729473 | Patricia Kelly | Social Worker | 6940 N Keating Ave, Lincolnwood, IL 60712-2408 | 2012-04-16 |
| 1306897087 | Fred T Waltzer | Social Worker | 6600 N Lincoln Ave, Suite 412, Lincolnwood, IL 60712-3620 | 2006-05-15 |
| 1700852662 | Edith Lynn Harshbarger | Social Worker | 7366 N Lincoln, Suite 406, Lincolnwood, IL 60712 | 2006-02-28 |
| 1578548574 | Howard S. Pollack | Social Worker | 7045 N Kilpatrick Ave, Lincolnwood, IL 60712-2128 | 2005-12-13 |
| 1124654371 | Chicago Center for Healthy Minds LLC | Social Worker | 4433 W Touhy Ave Ste 206, Lincolnwood, IL 60712-1833 | 2020-03-19 |
| 1932670627 | Maureen Ann Shayman | Social Worker | 4433 W Touhy Ave, Lincolnwood, IL 60712-1820 | 2018-12-06 |
| 1770020539 | Samantha Savin | Social Worker | 4433 W Touhy Ave # 335, Lincolnwood, IL 60712-1820 | 2017-01-31 |
| Find all providers in LINCOLNWOOD | ||||
| City | LINCOLNWOOD |
| Zip Code | 60712 |
Please comment or provide details below to improve the information on ILLUMINATION PSYCHOTHERAPY, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.