MONICA MICHELLE BULLOCK (NPI# 1629315288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629315288 |
Entity Type | Individual |
Full Name | MONICA MICHELLE BULLOCK |
Credential | LCPC |
Practice Address |
1535 Lake Cook Rd Suite 303 Northbrook IL 60062-1447 |
Mailing Address |
6441 W Warner Ave Apt 308 Chicago IL 60634-6227 |
Practice Telephone | 3125726120 |
Practice Fax Number | 8475599428 |
Enumeration Date | 2013-01-15 |
Last Update Date | 2015-02-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YP2500X |
Counselor Specialization: Professional |
180.009519 | IL | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | LCPC | 180.009519 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619409232 | Monica Bullock | Family Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2017-04-02 |
Street Address |
1535 LAKE COOK RD SUITE 303 |
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 |
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 |
1215258405 | Jennie Ozan | Psychologist | 1535 Lake Cook Rd, Suite 303, Northbrook, IL 60062-1447 | 2010-06-22 |
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 | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083240410 | Maribeth Gomez Germino | Counselor | 4201 Lake Cook Rd, Northbrook, IL 60062-1060 | 2020-03-17 |
1295389948 | Alice Shierk-booth | Counselor | 3000 Dundee Rd Ste 311, Northbrook, IL 60062-2434 | 2019-07-31 |
1457853558 | Barbara Dianne Demetrius-lallas | Counselor | 1859 Penfold Pl, Northbrook, IL 60062-6034 | 2018-03-05 |
1174032007 | Melissa Martin | Counselor | 5 Revere Dr Ste 100, Northbrook, IL 60062-1567 | 2017-09-22 |
1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
1104360080 | Pamela Matos | Counselor | 3100 Dundee Rd Ste 101, Northbrook, IL 60062-2462 | 2016-12-12 |
1811374960 | Aaron Marsh | Counselor | 155 Revere Dr Ste 11, Northbrook, IL 60062-1558 | 2015-04-28 |
1811315526 | Tracy K Durkan | Counselor | 1535 Lake Cook Rd Ste 303, Northbrook, IL 60062-1452 | 2014-03-31 |
1780029652 | Jennifer Welbel | Counselor | 1500 Skokie Blvd Ste 305, Northbrook, IL 60062-4114 | 2013-05-06 |
1477852341 | Jane Ward Carlton | Counselor | 1363 Shermer Rd Ste 313, Northbrook, IL 60062-4575 | 2011-03-17 |
Find all providers in NORTHBROOK |
City | NORTHBROOK |
Zip Code | 60062 |
Please comment or provide details below to improve the information on MONICA MICHELLE BULLOCK.
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.