Organization Active NPI

Lakeshore Psychology Group LLC

  • Clinical Psychologist
  • Northbrook, IL
National Provider Identifier
1558744326
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
LAKESHORE PSYCHOLOGY GROUP LLC
Practice address
601 Skokie Blvd
Suite 104
Northbrook, IL 60062-2851
Phone
(847) 564-1800
NPI assigned
Jun 29, 2015
Last updated
Jun 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Authorized official

Name
Dr. Elissa Geier, PSY.D.NPI 1801074745
Title
Member
Phone
(847) 564-1800

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
Clinical Psychologist 103TC0700X IL Primary

Addresses

Primary practice location

601 Skokie Blvd
Suite 104
Northbrook, IL 60062-2851

Mailing address

320 Grove St
Glencoe, IL 60022-2056

National Provider Directory

National Provider Directory

Locations

601 Skokie Blvd
Ste 104
Northbrook, IL 60062
Phone (847) 564-1800

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1558744326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 GROVE ST",
            "city": "GLENCOE",
            "state": "IL",
            "postal_code": "600222056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SKOKIE BLVD",
            "address_2": "SUITE 104",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622851",
            "telephone_number": "847-564-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE PSYCHOLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "GEIER",
        "authorized_official_first_name": "ELISSA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "847-564-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "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 Jun 29, 2015; 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.