| Energize Group, Inc | |
|
263 Skokie Blvd Northbrook IL 60062-1611 | |
| (773) 387-3577 | |
| (847) 584-2604 |
| Full Name | Energize Group, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 263 Skokie Blvd, Northbrook, Illinois |
| Authorized Official Name and Position | Tanya Strick (PRESIDENT) |
| Authorized Official Contact | 7733873577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Energize Group, Inc 4950 Madison St Unit 1391 Skokie IL 60076-7637 Ph: (773) 387-3577 | Energize Group, Inc 263 Skokie Blvd Northbrook IL 60062-1611 Ph: (773) 387-3577 |
| NPI Number | 1295389666 |
|---|---|
| Provider Enumeration Date | 07/24/2019 |
| Last Update Date | 09/28/2022 |
| Certification Date | 09/28/2022 |
| Medicare PECOS PAC ID | 0840529715 |
|---|---|
| Medicare Enrollment ID | O20190903001937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295389666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Melanie Marie Amin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407057581 PECOS PAC ID: 6709958713 Enrollment ID: I20080709000151 |
| Provider Name | Payal Sud |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851681944 PECOS PAC ID: 3870746274 Enrollment ID: I20130115000425 |
| Provider Name | Mary Alice Off |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841542917 PECOS PAC ID: 2961635396 Enrollment ID: I20140508002022 |
| Provider Name | Charles Preyar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851548176 PECOS PAC ID: 7810208378 Enrollment ID: I20150624002367 |
| Provider Name | Cindy Kirshman Gradle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891113312 PECOS PAC ID: 9931415262 Enrollment ID: I20150902000248 |
| Provider Name | Caryl M Noble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215482021 PECOS PAC ID: 2062707144 Enrollment ID: I20160829001764 |
| Provider Name | Celia E Hardamon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841678851 PECOS PAC ID: 1759661044 Enrollment ID: I20161202000266 |
| Provider Name | Karnesha Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548611791 PECOS PAC ID: 1456680255 Enrollment ID: I20190904000107 |
| Provider Name | Loren Jessica Havrilla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376095364 PECOS PAC ID: 3577995661 Enrollment ID: I20191111002276 |
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