Organization Active NPI

Brainbody PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1306523873
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BRAINBODY PLLC
Practice address
5250 Old Orchard Rd
Skokie, IL 60077-4460
Phone
(773) 885-8004
NPI assigned
Jun 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Authorized official

Name
Simcha Cohen, APNP
Title
Owner
Phone
(773) 885-8004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

5250 Old Orchard Rd
Skokie, IL 60077-4460

Mailing address

5250 Old Orchard Rd
Skokie, IL 60077-4460
Phone (773) 885-8004

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725235200000",
    "number": "1306523873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 OLD ORCHARD RD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774460",
            "telephone_number": "773-885-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 OLD ORCHARD RD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774460",
            "telephone_number": "773-885-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAINBODY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-28",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "SIMCHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-885-8004",
        "authorized_official_credential": "APNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; 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.