MICHAEL J BALTHAZOR (NPI# 1386882793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386882793 |
| Entity Type | Individual |
| Full Name | MICHAEL J BALTHAZOR |
| Credential | PH.D. |
| Practice Address |
4711 Golf Rd Suite 1100 Skokie IL 60076-1224 |
| Practice Telephone | 8479339339 |
| Practice Fax Number | 8479330874 |
| Mailing Telephone | 8479339339 |
| Mailing Fax Number | 8479330874 |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2009-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071-006684 | IL | Behavioral Health & Social Service Providers |
| Street Address |
4711 GOLF RD SUITE 1100 |
| City | SKOKIE |
| State | IL |
| Zip Code | 60076-1224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497752893 | Alice Chen | Legal Medicine | 4711 Golf Rd, Suite 808, Skokie, IL 60076-1224 | 2005-06-30 |
| 1811418015 | Pr Orthotics & Ot LLC | Durable Medical Equipment & Medical Supplies | 4711 Golf Rd, Skokie, IL 60076-1224 | 2017-06-28 |
| 1528507548 | Elizabeth Hultman | Nurse Practitioner | 4711 Golf Rd, Skokie, IL 60076-1224 | 2017-02-23 |
| 1609314616 | Mary Lally | Behavioral Analyst | 4711 Golf Rd, Suite 100, Skokie, IL 60076-1224 | 2017-02-09 |
| 1821536822 | Steinberg Behavior Solutions | Community/Behavioral Health | 4711 Golf Rd, Suite 100, Skokie, IL 60076-1224 | 2017-02-09 |
| 1205372067 | Olasunkanmi Ogedegbe | Nurse Practitioner | 4711 Golf Rd, Suite 1250, Skokie, IL 60076-1224 | 2017-01-17 |
| 1952858409 | Marissa Bennett | Behavioral Analyst | 4711 Golf Rd, 100, Skokie, IL 60076-1224 | 2016-09-01 |
| 1326495243 | Michelle Fisher | Social Worker | 4711 Golf Rd, Suite 400, Skokie, IL 60076-1224 | 2016-05-20 |
| 1336503119 | Rebecca Arends | Counselor | 4711 Golf Rd, Suite 1200, Skokie, IL 60076-1224 | 2016-04-07 |
| 1992169015 | Jarret Helstern | Nurse Practitioner | 4711 Golf Rd, Suite 1200, Skokie, IL 60076-1224 | 2016-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902456999 | Gateway Foundation, Inc | Clinic/Center | 4028 W. Dempster, Ste 100, Skokie, IL 60076 | 2019-09-12 |
| 1336798255 | Renee Rosenberg | Speech-Language Pathologist | C/o East Prairie School, 7616 N. East Prairie Road, Skoke, IL 60076 | 2019-09-04 |
| 1710531223 | Dw Care Solutions | Hospice Care, Community Based | 4556 Oakton St, Suite 205, Skokie, IL 60076 | 2019-08-01 |
| 1689228157 | Elaine Ng | Pharmacist | 9650 Gross Point Rd Suite 4900, Skokie, IL 60076 | 2019-08-01 |
| 1881169381 | Kathleen Pyles | Registered Nurse | 9650 Gross Point Rd # 4900, Skokie, IL 60076 | 2018-10-10 |
| 1174013452 | Vitae Health of Illinois LLC | Social Worker | 3450 Oakton St, Skokie, IL 60076 | 2018-05-13 |
| 1396253530 | Jodi Novick Okner | Social Worker | 9134 Kilbourn Avenue, Skokie, IL 60076 | 2018-01-22 |
| 1700335924 | Olumide Adeyemo | Nurse Practitioner | 4711 Golf Rd Suite 1250, Skokie, IL 60076 | 2016-09-28 |
| 1255705315 | Malka Rokach | Pharmacist | 3358 W Touhy, Skokie, IL 60076 | 2015-11-30 |
| 1578932620 | Katrina Margaret Keithley | Physician Assistant | 9669 Kenton Ave Ste 203, Skokie, IL 60076 | 2015-09-18 |
| Find all providers in zip 60076 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184258808 | Cleminson Psychological Services, LLC | Psychologist | 9933 Lawler Ave Ste 324, Skokie, IL 60077-3730 | 2020-03-03 |
| 1427575380 | Heather Stephenson | Psychologist | 9501 Lawler Ave, Skokie, IL 60077-1274 | 2017-08-23 |
| 1376071886 | Marla Debra Miller | Psychologist | 4040 Enfield Ave, Skokie, IL 60076-1934 | 2017-05-28 |
| 1790152635 | Jessica Ellen Dubnow | Psychologist | 5550 Touhy Ave Ste 404, Skokie, IL 60077-3253 | 2015-08-26 |
| 1770830275 | David N. Gershan | Psychologist | 8053 Kolmar Ave, Skokie, IL 60076-3114 | 2012-08-14 |
| 1326326778 | Patricia S Cochran | Psychologist | 8707 Skokie Blvd Ste 310, Skokie, IL 60077-2281 | 2011-08-02 |
| 1962719013 | Paul Thomas Riel | Psychologist | 8540 Leclaire St, Skokie, IL 60077-2135 | 2010-09-10 |
| 1750569224 | Mary Frances Schneider | Psychologist | 5323 Galitz St, Skokie, IL 60077-2712 | 2008-02-06 |
| 1598944530 | Laura S. Trakhtman | Psychologist | 8936 Niles Center Rd # D, Skokie, IL 60076-1847 | 2007-10-26 |
| 1780885772 | Nydia Lelia Welles | Psychologist | 4019 Church St, Skokie, IL 60076-1773 | 2007-05-29 |
| Find all providers in SKOKIE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.