| Family Service Center Of Wilmette Glenview Northbrook Kenilworth | |
|
191 Waukegan Rd Ste 206 Northfield IL 60093-2743 | |
| (847) 251-7350 | |
| (847) 853-2600 |
| Full Name | Family Service Center Of Wilmette Glenview Northbrook Kenilworth |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 191 Waukegan Rd Ste 206, Northfield, Illinois |
| Authorized Official Name and Position | Rachel German (OFFICE MANAGER) |
| Authorized Official Contact | 8472517350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Service Center Of Wilmette Glenview Northbrook Kenilworth 191 Waukegan Rd Ste 206 Northfield IL 60093-2743 Ph: (847) 251-7350 | Family Service Center Of Wilmette Glenview Northbrook Kenilworth 191 Waukegan Rd Ste 206 Northfield IL 60093-2743 Ph: (847) 251-7350 |
| NPI Number | 1750396289 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 10/05/2023 |
| Certification Date | 10/05/2023 |
| Medicare PECOS PAC ID | 9739085549 |
|---|---|
| Medicare Enrollment ID | O20031211000669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750396289 | NPI | - | NPPES |
| 1605635 | Other | IL | BLUE CROSS BLUE SHIELD |
| Provider Name | Laurie D Roston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366450645 PECOS PAC ID: 3375637333 Enrollment ID: I20070920000794 |
| Provider Name | Richard A Moorman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346665841 PECOS PAC ID: 2769605849 Enrollment ID: I20140516001702 |
| Provider Name | Alan B Trachtenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285982330 PECOS PAC ID: 6709194970 Enrollment ID: I20151008000358 |
| Provider Name | Renee Z Dominguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821131590 PECOS PAC ID: 6305140211 Enrollment ID: I20160217000693 |
| Provider Name | Nanci J Priest |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669885810 PECOS PAC ID: 2961709688 Enrollment ID: I20160324000279 |
| Provider Name | Robin L Lake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881085447 PECOS PAC ID: 2466772025 Enrollment ID: I20160405002130 |
| Provider Name | Kenneth J Catalanotte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790817658 PECOS PAC ID: 1355627720 Enrollment ID: I20170419001995 |
| Provider Name | Amelia Eades Koplow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316439037 PECOS PAC ID: 4183084650 Enrollment ID: I20230714002913 |
| Provider Name | Ralph Yaniz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427439645 PECOS PAC ID: 7810334877 Enrollment ID: I20240326002266 |
| Provider Name | Karen Cloyd |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891927067 PECOS PAC ID: 3870935430 Enrollment ID: I20240528002817 |
| Provider Name | Jarrett Langfitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487288148 PECOS PAC ID: 5991191355 Enrollment ID: I20240730004515 |
| Provider Name | Laura Irene Valiukenas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346837499 PECOS PAC ID: 4688108947 Enrollment ID: I20241108000735 |
| Provider Name | Phyllis Kui Grady |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1245819986 PECOS PAC ID: 6709307390 Enrollment ID: I20250312001026 |
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