Organization Active NPI

North Shore Brain and Body Inc

  • Physical Therapist
  • Libertyville, IL
National Provider Identifier
1053908673
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NORTH SHORE BRAIN AND BODY INC
Practice address
1590 S Milwaukee Ave Ste 211
Libertyville, IL 60048-3785
Phone
(224) 688-7710
NPI assigned
Dec 29, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Cathleen Ellen Bender, PTNPI 1851405609
Title
Owner
Phone
(224) 688-7710

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1590 S Milwaukee Ave Ste 211
Libertyville, IL 60048-3785

Mailing address

926 Clark Dr
Gurnee, IL 60031-3115
Phone (224) 688-7710

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 29, 2020.

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1053908673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 CLARK DR",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313115",
            "telephone_number": "224-688-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 S MILWAUKEE AVE STE 211",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483785",
            "telephone_number": "224-688-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE BRAIN AND BODY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "BENDER",
        "authorized_official_first_name": "CATHLEEN",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-688-7710",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.