MAXIM A CHASANOV, MD SC (NPI# 1033245105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033245105 |
| Entity Type | Organization |
| Organization Name | MAXIM A CHASANOV, MD SC |
| Practice Address |
1535 Lake Cook Rd Suite 112 Northbrook IL 60062-1447 |
| Mailing Address |
1535 Lake Cook Road Suite 112 Northbrook IL 60062-1447 |
| Practice Telephone | 8473630817 |
| Practice Fax Number | 8475097984 |
| Mailing Telephone | 8473630817 |
| Mailing Fax Number | 8475097984 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-12-24 |
| Authorized Official Name | DR. MAXIM ALEXIS CHASANOV (PRESIDENT) |
| Authorized Official Telephone | 8473630817 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
036084874 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS/BLUE SHIELD | 1606 781 | 01 |
| Street Address |
1535 LAKE COOK RD SUITE 112 |
| City | NORTHBROOK |
| State | IL |
| Zip Code | 60062-1447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306849252 | Steven Neal Kacel | Dentist | 1535 Lake Cook Rd, Ste 107, Northbrook, IL 60062-1450 | 2005-05-24 |
| 1841736402 | Audrey Grunst Lcsw | Counselor | 1535 Lake Cook Rd, Sute 303, Northbrook, IL 60062-1447 | 2017-01-06 |
| 1801339684 | Anna Lynn Kreiser | Dietitian, Registered | 1535 Lake Cook Rd, Suite 303, Northbrook, IL 60062-1447 | 2016-11-28 |
| 1528476694 | Jennifer Mandell | Specialist | 1535 Lake Cook Rd, 112, Northbrook, IL 60062-1447 | 2014-08-01 |
| 1003248378 | Break4health | Health Maintenance Organization | 1535 Lake Cook Rd, #112, Northbrook, IL 60062-1447 | 2013-08-08 |
| 1629315288 | Monica Michelle Bullock | Counselor | 1535 Lake Cook Rd, Suite 303, Northbrook, IL 60062-1447 | 2013-01-15 |
| 1164768073 | Jill Perez | Counselor | 1535 Lake Cook Rd, Northbrook, IL 60062-1447 | 2012-12-20 |
| 1740540178 | Michael A. Epstein Md Sc | Specialist | 1535 Lake Cook Rd, Suite 211, Northbrook, IL 60062-1447 | 2012-05-18 |
| 1558629212 | David I. Rosen, M.d. Ltd | Internal Medicine | 1535 Lake Cook Rd, 401, Northbrook, IL 60062-1447 | 2012-05-01 |
| 1184934523 | Beth W. Ross | Counselor | 1535 Lake Cook Rd, Suite 111, Northbrook, IL 60062-1447 | 2010-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487067 | Cvs Aoc Services, L.L.C. | Optometrist | 936 Willow Road, Store 0141, Northbrook, IL 60062 | 2020-05-06 |
| 1386103885 | Jennifer Venegas | Behavior Technician | 5 Revere Dr Suit 120, Northbrook, IL 60062 | 2019-03-14 |
| 1720558281 | Taylor Hundley | Behavior Technician | 5 Revere Dr. Suite 120, Northbrook, IL 60062 | 2018-11-27 |
| 1609344027 | Melissa Cepeda | Behavior Technician | 5 Revere Dr Suite 120, Northbrook, IL 60062 | 2018-11-03 |
| 1235606658 | Candace Cheyenne Kaiser | Behavior Technician | 5 Revere Dr, Suite 120, Northbrook, IL 60062 | 2018-10-24 |
| 1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
| 1467984773 | Ayzenshteyn Chiropractic | Chiropractor | 3210 Doolittle Dr., Northbrook, IL 60062 | 2017-03-28 |
| 1396282695 | Josephine Driscoll | Physician Assistant | 400 Skokie Blvd., Suite 450, Northbrook, IL 60062 | 2017-01-24 |
| 1396297842 | Lauren Raphael Lcsw LLC | Social Worker | 3050 Pheasant Creek Drive, Apt. 104, Northbrook, IL 60062 | 2016-11-01 |
| 1851847073 | Jassim Vailoces | Physical Therapist | 634 Academy Dr, Northbrook, IL 60062 | 2016-08-28 |
| Find all providers in zip 60062 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588054647 | Brandon C. Gimbel, M.d., LLC | Psychiatry & Neurology | 333 Skokie Blvd Ste 114, Northbrook, IL 60062-1624 | 2015-01-28 |
| 1891114740 | Thomas Duffy | Psychiatry & Neurology | 3829 Eastwind Ct, Northbrook, IL 60062-4205 | 2014-04-08 |
| 1669635108 | Firuza Aliyeva | Psychiatry & Neurology | 1450 Techny Rd, Northbrook, IL 60062-5447 | 2008-07-03 |
| 1528247558 | Apollo C. Solecki M.d., S.c. | Psychiatry & Neurology | 3749 Techny Rd, Northbrook, IL 60062-5757 | 2007-10-26 |
| 1356533269 | Kenzie Kitcharoen | Psychiatry & Neurology | 155 Revere Dr Ste 4, Northbrook, IL 60062-1558 | 2007-08-14 |
| 1922146729 | Robert Lee Rosenfeld | Psychiatry & Neurology | 801 Skokie Blvd, Suite 212, Northbrook, IL 60062 | 2007-02-02 |
| 1477605434 | Todd H. Kasdan | Psychiatry & Neurology | 2507 Illinois Rd, Northbrook, IL 60062-5242 | 2007-01-18 |
| 1013075829 | Joshua Kahn | Psychiatry & Neurology | 450 Skokie Blvd, Suite 504, Northbrook, IL 60062-7913 | 2006-12-05 |
| 1255401212 | Rafael Pedro Carreira | Psychiatry & Neurology | 2785 Appletree Lane, Northbrook, IL 60062-3407 | 2006-11-08 |
| 1700981859 | Suh New Hope Clinics,ltd. | Psychiatry & Neurology | 3635 Whirlaway Dr, Suite #2, Northbrook, IL 60062-6311 | 2006-09-13 |
| Find all providers in NORTHBROOK | ||||
| City | NORTHBROOK |
| Zip Code | 60062 |
Please comment or provide details below to improve the information on MAXIM A CHASANOV, MD SC.
| 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.