Michael Connell, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

106001254 Issued in IL

Practice address

3375 Commercial Ave Ste 10
Northbrook, IL 60062-1908

Phone

(312) 438-8654

NPI assigned

May 30, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1245768647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4732 N AUSTIN AVE UNIT 405",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303796",
            "telephone_number": "847-921-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 COMMERCIAL AVE STE 10",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621908",
            "telephone_number": "312-438-8654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Winnetka",
            "state": "IL",
            "postal_code": "600932238",
            "country_code": "US",
            "telephone_number": "847-814-1096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "106001254",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "208000367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.