NPIMap

Organization Active NPI

Family Service Center of Wilmette Glenview Northbrook Kenilworth

  • Marriage & Family Therapist
  • Northfield, IL
National Provider Identifier
1750396289
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
FAMILY SERVICE CENTER OF WILMETTE GLENVIEW NORTHBROOK KENILWORTH
Practice address
191 Waukegan Rd Ste 206
Northfield, IL 60093-2743
Phone
(847) 251-7350
Fax
(847) 853-2600
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Rachel German
Title
Office Manager
Phone
(847) 251-7350

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X IL
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X IN
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X IL
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X IL Primary

Addresses

Primary practice location

191 Waukegan Rd Ste 206
Northfield, IL 60093-2743

Mailing address

191 Waukegan Rd Ste 206
Northfield, IL 60093-2743
Phone (847) 251-7350

Other identifiers 1

IdentifierTypeStateIssuer
1605635OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Family Service Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031211000669 IL Part B Supplier - Clinic/Group Practice 9739085549 Receives reassigned benefits from 11 practitioners
Practice locations: Northfield, IL

National Provider Directory

National Provider Directory

Locations

425 Huehl Rd
#200
Northbrook, IL 60062
Phone (847) 251-7350

191 Waukegan Rd
Ste 206
Northfield, IL 60093
Phone (847) 251-7350

3545 Lake Ave
Ste 200
Wilmette, IL 60091
Phone (847) 251-7350

1167 Wilmette Ave
Wilmette, IL 60091
Phone (847) 251-7350

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1750396289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 WAUKEGAN RD STE 206",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600932743",
            "telephone_number": "847-251-7350",
            "fax_number": "847-853-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 WAUKEGAN RD STE 206",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600932743",
            "telephone_number": "847-251-7350",
            "fax_number": "847-853-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE CENTER OF WILMETTE GLENVIEW NORTHBROOK KENILWORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "GERMAN",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-251-7350"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1605635",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Service Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Service Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.