NORTH SHORE PSYCHOTHERAPY, LLC (NPI# 1154814713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154814713 |
| Entity Type | Organization |
| Organization Name | NORTH SHORE PSYCHOTHERAPY, LLC |
| Practice Address |
2502 N Clark St Chicago IL 60614-1850 |
| Mailing Address |
615 Euclid Ct Highland Park IL 60035-1271 |
| Practice Telephone | 8477785533 |
| Mailing Telephone | 8473238189 |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-09-25 |
| Authorized Official Name | JODY K ROTBLATT (OWNER) |
| Authorized Official Telephone | 8473238189 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
149018766 | IL | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071008109 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS-IL | 1982122412 | 01 |
| IL | BCBS-IL | 1487872735 | 01 |
| Other Name | Type Code |
|---|---|
| North Shore City Psychotherapy Associates | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 420 Lake Cook Rd Ste 113, Deerfield, IL 60015 | 8573238189 | |
| 2502 N Clark St, Chicago, IL 606141850 | 8477785533 |
| Street Address |
2502 N CLARK ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-1850 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851365159 | Barbara Samuels | Social Worker | 2502 N Clark St, Suite 213, Chicago, IL 60614-1850 | 2006-02-14 |
| 1720480213 | Anne M. Appel, LLC | Counselor | 2502 N Clark St, Suite 221, Chicago, IL 60614-1850 | 2014-09-16 |
| 1295070605 | Hillary L Schoninger | Social Worker | 2502 N Clark St, #221, Chicago, IL 60614-1850 | 2012-12-11 |
| 1992078331 | Anne Marie Appel | Counselor | 2502 N Clark St, Suite 221, Chicago, IL 60614-1850 | 2012-02-15 |
| 1902924160 | Ariel David, M.d., S.c. | Psychiatry & Neurology | 2502 N Clark St, #8215, Chicago, IL 60614-1850 | 2007-03-27 |
| 1093833246 | Ariel David | Psychiatry & Neurology | 2502 N Clark St, #215, Chicago, IL 60614-1850 | 2007-03-27 |
| 1356472708 | Phyllis Mandler | Social Worker | 2502 N Clark St, Chicago, IL 60614-1850 | 2007-03-08 |
| 1528135910 | Richard Wendel | Marriage & Family Therapist | 2502 N Clark St, Chicago, IL 60614-1850 | 2006-11-29 |
| 1548341217 | Symed, Inc. | Durable Medical Equipment & Medical Supplies | 2502 N Clark St, Ste. 212, Chicago, IL 60614-1850 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699166 | Jennifer Knuepfer, Psyd, Pllc | Psychologist | 4256 N Ravenswood Ave Ste 305, Chicago, IL 60613-1114 | 2020-11-03 |
| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1730792151 | Jenny Marie Wamsat | Psychologist | 1921 W Diversey Pkwy Apt 402, Chicago, IL 60614-9412 | 2020-08-25 |
| 1497365910 | Sara Sirota | Psychologist | 5443 N Broadway St # 2s, Chicago, IL 60640-1703 | 2020-08-10 |
| 1053920512 | Alyse Renae Bedell | Psychologist | 5841 S Maryland Ave Ste 300, Chicago, IL 60637-1443 | 2020-07-30 |
| 1699392688 | Hongying Chen | Psychologist | 720 W Sheridan Rd Apt 3s, Chicago, IL 60613-3252 | 2020-06-25 |
| Find all providers in CHICAGO | ||||
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| 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.