NPIMap

Organization Active NPI

North Shore Wellness Center

  • Behavior Analyst
  • Northbrook, IL
National Provider Identifier
1417196288
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
NORTH SHORE WELLNESS CENTER
Practice address
606 Academy Dr
Northbrook, IL 60062-2421
Phone
(847) 559-0680
Fax
(847) 559-0859
NPI assigned
Feb 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Authorized official

Name
Mr. Leonard T Carr, M.D.
Title
President
Phone
(847) 559-0680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

606 Academy Dr
Northbrook, IL 60062-2421

Mailing address

606 Academy Dr
Northbrook, IL 60062-2421
Phone (847) 559-0680

National Provider Directory

National Provider Directory
Tax ID family
North Shore Wellness Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1417196288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 ACADEMY DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622421",
            "telephone_number": "847-559-0680",
            "fax_number": "847-559-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 ACADEMY DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622421",
            "telephone_number": "847-559-0680",
            "fax_number": "847-559-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-559-0680",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "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 Feb 18, 2009; 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.