NPIMap

Organization Active NPI

The Renfrew Center of Illinois

  • Professional Counselor
  • Northbrook, IL
National Provider Identifier
1275058745
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.012613 Issued in IL
Legal business name
THE RENFREW CENTER OF ILLINOIS
Practice address
5 Revere Dr, Suite 100
Northbrook, IL 60062
Phone
(847) 291-6805
Fax
(847) 291-6815
NPI assigned
Aug 7, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Melissa Martin, LPCNPI 1174032007
Title
Primary Therapist
Phone
(847) 291-6805

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.012613 IL Primary

Addresses

Primary practice location

5 Revere Dr, Suite 100
Northbrook, IL 60062

Mailing address

5 Revere Dr Ste 100
Northbrook, IL 60062-1567
Phone (847) 291-6805

National Provider Directory

National Provider Directory

Locations

5 Revere Dr
Ste 100
Northbrook, IL 60062
Phone (847) 291-6805

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1275058745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 REVERE DR STE 100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621567",
            "telephone_number": "847-291-6805",
            "fax_number": "847-291-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 REVERE DR, SUITE 100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60062",
            "telephone_number": "847-291-6805",
            "fax_number": "847-291-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RENFREW CENTER OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PRIMARY THERAPIST",
        "authorized_official_telephone_number": "847-291-6805",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.012613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.