NPIMap

The Josselyn Center NFP

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Northbrook, IL

NPI 1073548640 · NPPES record last updated May 6, 2025

Key facts

NPI
1073548640
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
THE JOSSELYN CENTER NFP
Practice address
1135 Skokie Blvd
Northbrook, IL 60062-4118
Phone
(847) 441-5600
Fax
(847) 441-7968
NPI assigned
Jul 12, 2006
Organization subpart
No

Authorized official

Name
Ms. Susan D Resko
Title
President
Phone
(847) 441-5600

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 157

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

View all 157

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050525000069 IL Part B Supplier - Clinic/Group Practice 0840289740 Receives reassigned benefits from 144 practitioners
4 other NPIs on this enrollment
Practice locations: Northbrook, IL; Waukegan, IL; Northfield, IL; Grayslake, IL

National Provider Directory

Tax ID family
The Josselyn Center (13 organizations share this tax ID)

Locations

1850 Oak St
Northfield, IL 60093
Phone (224) 255-6377

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor
Group: 193200000X MULTI-SPECIALTY GROUP		 101Y00000X
Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103T00000X
Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP		 104100000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes

Addresses

Primary practice location

1135 Skokie Blvd
Northbrook, IL 60062-4118

Mailing address

1135 Skokie Blvd
Northbrook, IL 60062-4118
Phone (847) 441-5600

Other identifiers

IdentifierTypeStateIssuer
036054322MedicaidIL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 6, 2025.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1073548640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 SKOKIE BLVD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624118",
            "telephone_number": "847-441-5600",
            "fax_number": "847-441-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 SKOKIE BLVD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624118",
            "telephone_number": "847-441-5600",
            "fax_number": "847-441-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JOSSELYN CENTER NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A",
        "authorized_official_last_name": "RESKO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-441-5600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054322",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

All providers in Northbrook, IL · Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

Sources for this page

Verify at the official NPI Registry.