| North Shore Therapy Pllc | |
|
550 Michigan Ave Apt 3 Evanston IL 60202-4658 | |
| (312) 509-0785 | |
| Not Available |
| Full Name | North Shore Therapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 550 Michigan Ave Apt 3, Evanston, Illinois |
| Authorized Official Name and Position | Caroline Kroe (OWNER) |
| Authorized Official Contact | 3125090785 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore Therapy Pllc 550 Michigan Ave Apt 3 Evanston IL 60202-4658 Ph: (312) 509-0785 | North Shore Therapy Pllc 550 Michigan Ave Apt 3 Evanston IL 60202-4658 Ph: (312) 509-0785 |
| NPI Number | 1558966028 |
|---|---|
| Provider Enumeration Date | 12/02/2020 |
| Last Update Date | 12/02/2020 |
| Certification Date | 12/02/2020 |
| Medicare PECOS PAC ID | 9436564671 |
|---|---|
| Medicare Enrollment ID | O20210219001604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558966028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Caroline Kroe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093858300 PECOS PAC ID: 4981837531 Enrollment ID: I20140506000389 |
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