| 360 Degrees Wellness & Coaching Llc | |
|
225 E Deerpath Suite 280 Lake Forest IL 60045-1952 | |
| (224) 619-6982 | |
| Not Available |
| Full Name | 360 Degrees Wellness & Coaching Llc |
|---|---|
| Speciality | Social Worker |
| Location | 225 E Deerpath, Lake Forest, Illinois |
| Authorized Official Name and Position | Sophia Shlain (OWNER) |
| Authorized Official Contact | 2246196982 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 360 Degrees Wellness & Coaching Llc 225 E Deerpath Suite 280 Lake Forest IL 60045-1952 Ph: (224) 619-6982 | 360 Degrees Wellness & Coaching Llc 225 E Deerpath Suite 280 Lake Forest IL 60045-1952 Ph: (224) 619-6982 |
| NPI Number | 1497176523 |
|---|---|
| Provider Enumeration Date | 12/16/2013 |
| Last Update Date | 12/16/2013 |
| Medicare PECOS PAC ID | 8426288978 |
|---|---|
| Medicare Enrollment ID | O20140228000226 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497176523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.011971 (Illinois) | Primary |
| Provider Name | Sophia Shlain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083838346 PECOS PAC ID: 9739272766 Enrollment ID: I20070907000426 |
| Provider Name | Garth Amundson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629133996 PECOS PAC ID: 2668548439 Enrollment ID: I20080911000592 |
| Provider Name | Matthew J Marder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841596475 PECOS PAC ID: 9931372513 Enrollment ID: I20111026000519 |
| Provider Name | Molly Z Oxman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346656865 PECOS PAC ID: 6406072651 Enrollment ID: I20140723001857 |
| Provider Name | Brandon A Markel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447685029 PECOS PAC ID: 9133340250 Enrollment ID: I20150212000513 |
| Provider Name | Matthew Selekman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134350671 PECOS PAC ID: 3779872676 Enrollment ID: I20160517000579 |
| Provider Name | Julie Y Palumbo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396072377 PECOS PAC ID: 7012285695 Enrollment ID: I20170623000093 |
| Provider Name | Katie A Salyer Szostak |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336633627 PECOS PAC ID: 1153670450 Enrollment ID: I20180820003398 |
| Provider Name | Andrea Christine Gaspar Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952655680 PECOS PAC ID: 0244659845 Enrollment ID: I20201001000637 |
| Provider Name | Jonathan Handrup |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295306322 PECOS PAC ID: 4688079080 Enrollment ID: I20210824000496 |
| Provider Name | Deborah Kronenberger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538582648 PECOS PAC ID: 1759724149 Enrollment ID: I20240213003333 |
| Provider Name | Jill Kreller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982836177 PECOS PAC ID: 0941644900 Enrollment ID: I20240216004347 |
| Provider Name | Claudia Talia-twyman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760749949 PECOS PAC ID: 6608212238 Enrollment ID: I20240306001100 |
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