Chicago Integrative Center for Psychology LLC
Organization Active NPI Psychiatry Physician · Lake Bluff, IL
NPI 1649785486 · NPPES record last updated Nov 15, 2021
Key facts
- NPI
- 1649785486
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- CHICAGO INTEGRATIVE CENTER FOR PSYCHOLOGY LLC
- Practice address
- 900 North Shore Dr Ste 120
Lake Bluff, IL 60044-2225 - Phone
- (847) 615-1698
- Fax
- (847) 615-1697
- NPI assigned
- Dec 1, 2017
- Organization subpart
- No
Authorized official
- Name
- Erin Bright
- Title
- Coo
- Phone
- (847) 615-1698
Practitioners 12
-
Danielle Marie Baran, PH.D.
-
Ryanne R Bright, LCPC, CADC
-
Maria E. Escobar, DSW, LCSW
-
Michael Ficaro, PMHNP-BC
-
Dina M Froustis, APRN, NP-C
-
Nicole Teresa Gehbauer, LCPC
-
John Hurd, LCSW
-
Wendy Lou McCarty, LMFT
-
Bradley M. Pechter, M.D.
-
Mark Shukhman, MD
-
Kelsey Ann Dadson, LICSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220126002063 | IL | Part B Supplier - Clinic/Group Practice | 6800288754 |
Receives reassigned benefits from 12 practitioners Practice locations: Lake Bluff, IL; Skokie, IL |
National Provider Directory
Locations
8707 Skokie Blvd
Ste 210
Skokie, IL 60077
Phone (847) 615-1698
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
900 North Shore Dr Ste 120
Lake Bluff, IL 60044-2225
Mailing address
900 North Shore Dr Ste 120
Lake Bluff, IL 60044-2225
Phone (847) 615-1698
Other practice location 1
8707 Skokie Blvd Ste 210
Skokie, IL 60077-2272
Phone (847) 615-1698 ext. 1302
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083632384 | Other | IL | NPI |
Other providers in Lake Bluff, IL
- Chase Counseling & Wellness LTD.
- Darissa Fernanda Chavarria
- Judy Ling Chen
- Cheryl Jackson OD PC
- Cheryl Perlis MD SC
- Child, Adolescent & Family Development Center
- Naly Choi
- Cynthia Huei-Chung Chou
- Wanda Ivette Cintron
- Claridge Operations LLC
All providers in Lake Bluff, IL · Psychiatry Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.