North Shore Family Wellness, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149011633 Issued in IL

Legal business name

NORTH SHORE FAMILY WELLNESS, LLC

Practice address

5225 Old Orchard Rd
Suite 34
Skokie, IL 60077-4405

Phone

(847) 231-3729

NPI assigned

Sep 24, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Keith Russell Bayer, LCSWNPI 1316996085

Title

Owner/Family Therapist

Phone

(847) 231-3729

Specialties & licenses 1

Addresses

Practitioners 3

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

• Keith Russell Bayer, LCSW

  • Clinical Social Worker
  • Skokie, IL
  • NPI 1316996085
  NPD Authorized official
• Sandy Chavez, LCPC

  • Mental Health Counselor
  • Skokie, IL
  • NPI 1407484165
  NPD
• Shaina Toulabi, MA, LCPC

  • Mental Health Counselor
  • Skokie, IL
  • NPI 1225734536
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1093066599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 OLD ORCHARD RD STE 46",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771027",
            "telephone_number": "847-231-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 OLD ORCHARD RD",
            "address_2": "SUITE 34",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774405",
            "telephone_number": "847-231-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE FAMILY WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-24",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "BAYER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER/FAMILY THERAPIST",
        "authorized_official_telephone_number": "847-231-3729",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Kathleen Norris Van Eaton, AU.D.
• North Shore Acupuncture Center
• North Shore Ambulatory Care, LLC
• North Shore Dermatology, S.C.
• North Shore Emotional Wellness PLLC
• North Shore Fertility, S.C.
• North Shore Gastroenterology SC
• North Shore Health Center
• North Shore Healthcare, Inc.
• North Shore Medicine S C

• Clinical Social Worker in Skokie, IL
• Providers in Skokie, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.