Northlake Mental Health Center LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

NORTHLAKE MENTAL HEALTH CENTER LLC

Practice address

7101 N Cicero Ave Ste 200
Lincolnwood, IL 60712-2112

Phone

(847) 452-4565

Fax

(985) 626-6559

NPI assigned

Jan 11, 2021

Organization subpart

Yes

Parent organization

NESS HEALTHCARE NFPAs reported in NPPES

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

Authorized official

Name

Tony Shir

Title

President

Phone

(847) 452-4565

Specialties & licenses 1

Addresses

Part of

Ness Healthcare NFP

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1669061008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 N CICERO AVE STE 200",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122112",
            "telephone_number": "847-452-4565",
            "fax_number": "985-626-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 N CICERO AVE STE 200",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122112",
            "telephone_number": "847-452-4565",
            "fax_number": "985-626-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAKE MENTAL HEALTH CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NESS HEALTHCARE NFP",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "SHIR",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-452-4565"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Lincolnwood, IL
• Providers in Lincolnwood, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.