Individual provider Active NPI

Cooper Houston Fredricksen, BSW

  • Social Worker
  • Northbrook, IL
National Provider Identifier
1750261087
Registry record updated Aug 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1135 Skokie Blvd
Northbrook, IL 60062-4118
Phone
(847) 441-5600
Fax
(847) 441-7968
NPI assigned
Sep 5, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X IL Primary

Addresses

Primary practice location

1135 Skokie Blvd
Northbrook, IL 60062-4118

Mailing address

1135 Skokie Blvd
Northbrook, IL 60062-4118
Phone (847) 441-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786233600000",
    "number": "1750261087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 SKOKIE BLVD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624118",
            "telephone_number": "847-441-5600",
            "fax_number": "847-441-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 SKOKIE BLVD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624118",
            "telephone_number": "847-441-5600",
            "fax_number": "847-441-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSEN",
        "first_name": "COOPER",
        "middle_name": "HOUSTON",
        "credential": "BSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-05",
        "last_updated": "2026-08-09",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "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 Aug 9, 2026; 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.