MISS JANICE B FOOTLIK (NPI# 1619954401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619954401 |
| Entity Type | Individual |
| Full Name | MISS JANICE B FOOTLIK |
| Credential | MA LCPC NCC CCCJS NA |
| Practice Address |
2521 Gross Point Rd 2nd Floor Evanston IL 60201-4993 |
| Mailing Address |
2526 Wellington Ct Evanston IL 60201-4975 |
| Practice Telephone | 8478669625 |
| Practice Fax Number | 8473286868 |
| Mailing Telephone | 8478669625 |
| Mailing Fax Number | 8473286868 |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | A17526 | Behavioral Health & Social Service Providers | |
| Y | 103T00000X | Psychologist | 1020090 | IL | Behavioral Health & Social Service Providers |
| N | 103T00000X | Psychologist | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | AETNA INS PROVIDER | 7481658 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 0007607959 | 01 |
| NAFC PROVIDER | 17526 | 01 |
| Street Address |
2521 GROSS POINT RD 2ND FLOOR |
| City | EVANSTON |
| State | IL |
| Zip Code | 60201-4993 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962898 | Sebastian Andres Cruz | Internal Medicine | Northshore University Healthsystem, Off of Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2020-05-06 |
| 1053970442 | Wade Gilman | Family Medicine | 1650 Ridge Ave, Ste 1304, Evanston, IL 60201 | 2019-06-10 |
| 1922577949 | Elizabeth Wilton Therapy, LLC | Counselor | 2901a Central St Ste 3, Evanston, IL 60201 | 2018-11-20 |
| 1952887812 | Sg Wellness LLC | Clinic/Center | 3008 Central Street, Evanston, IL 60201 | 2018-07-13 |
| 1689169591 | Michael Kert Zijlstra | Internal Medicine | Northshore University Healthsystem Office of Academic, Affairs 2650 Ridge Ave, Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1982199725 | Elizabeth Hannah Lees | Internal Medicine | Northshore University Healthsystem Office of Academic A, 2650 Ridge Ave Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1730674565 | Ashley Elizabeth Aller | Internal Medicine | Northshore University Healthsystem, Office Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1669967683 | Ayush N Shah | Internal Medicine | 2650 Ridge Ave Ste 5315, Evanston, IL 60201 | 2018-06-22 |
| 1811481062 | Jeffrey D. Brow | Internal Medicine | 2650 Ridge Ave Rm 5315, Evanston, IL 60201 | 2018-06-20 |
| 1831687250 | Michael Patrick Murphy | Radiology | 807 Davis St. Unit 707, Evanston, IL 60201 | 2018-05-01 |
| Find all providers in zip 60201 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528571593 | Brooke P. Halpern | Psychologist | 636 Church St Ste 507, Evanston, IL 60201-4581 | 2017-11-13 |
| 1326440454 | Jennifer C. Panning Psyd and Associates | Psychologist | 636 Church St., Ste. 510, Evanston, IL 60201-4508 | 2014-09-19 |
| 1679984132 | Sean W. Harrell | Psychologist | 89 S Valley Dr Apt 22, Evanston, WY 82930-4887 | 2014-05-17 |
| 1174809990 | Michelle Doniece Morrone-kubes | Psychologist | 636 Church St Ste 619, Evanston, IL 60201-4586 | 2011-10-25 |
| 1942503800 | Barbara Richardson | Psychologist | 225 Richmond St, Evanston, IL 60202-3639 | 2010-12-15 |
| 1649440645 | Laura Lynn Viner | Psychologist | 1560 Sherman Ave., Suite 400, Yellowbrick, Evanston, IL 60201-4803 | 2008-03-05 |
| 1144408980 | Inna Meerson | Psychologist | 917 Washington St Apt 1n, Evanston, IL 60202-2289 | 2008-02-04 |
| 1093912644 | Donald J Miro | Psychologist | 1889 Maple Ave Unit W2, Evanston, IL 60201-3169 | 2007-06-28 |
| 1790986313 | Katelyn S Varhely | Psychologist | 114 Kedzie St, Evanston, IL 60202-2510 | 2007-05-30 |
| 1073643102 | Susanne Streicker | Psychologist | 607 Lake St, Evanston, IL 60201-4412 | 2007-03-07 |
| Find all providers in EVANSTON | ||||
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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.