MICHAEL DOUGLAS JR. (NPI# 1972908770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972908770 |
| Entity Type | Individual |
| Full Name | MICHAEL DOUGLAS JR. |
| Practice Address |
1845 Grandstand Place Elgin IL 60123 |
| Mailing Address |
152 Town Center Blvd Gilberts IL 60136 |
| Practice Telephone | 8476950484 |
| Mailing Telephone | 8478152590 |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437203544 | Michael Kirk Douglas | Counselor | 1303 Kent Avenue, Baltimore, MD 21207-4828 | 2007-01-23 |
| 1932296373 | Michael Douglas | Internal Medicine | 1920 Gunbarrel Rd, Suite 110, Chattanooga, TN 37421-3100 | 2006-10-06 |
| 1902907454 | Michael Lee Douglas | Family Medicine | 1110 Bergslien Street, Baldwin, WI 54002 | 2006-09-26 |
| 1407853088 | Michael L Douglas | Chiropractor | 4140 Nw 12th St, Lauderhill, FL 33313-5816 | 2005-06-28 |
| 1497246011 | Michael Douglas II | Case Manager/Care Coordinator | 2116 Justice St, Monroe, LA 71201-3618 | 2018-05-21 |
| 1639523665 | Michael Stephen Douglas | Anesthesiology | 11234 Anderson St, Department of Anesthesiology, Loma Linda, CA 92354 | 2016-04-15 |
| 1902169543 | Michael L Douglas | Urology | 425 Bmh Physicians Office Bldg, Maryville, TN 37804 | 2012-06-19 |
| 1841572856 | Michael Anthony Douglas | Counselor | 4760 Sepulveda Blvd, Culver City, CA 90230-4820 | 2011-09-15 |
| 1659679785 | Michael L Douglas | Counselor | 1523 N Boston Pl, Tulsa, OK 74106-4103 | 2011-03-14 |
| 1073736559 | Michael Adam Douglas | Psychologist | 11704 Wilshire Blvd, Suite 255, Los Angeles, CA 90025-1507 | 2007-04-11 |
| Street Address |
1845 GRANDSTAND PLACE |
| City | ELGIN |
| State | IL |
| Zip Code | 60123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982787693 | Ecker Center for Behavioral Health | Community Based Residential Treatment Facility, Mental Illness | 1845 Grandstand Place, Elgin, IL 60123 | 2006-10-24 |
| 1750990115 | Michael Chammany | Counselor | 1845 Grandstand Place, Elgin, IL 60123-4983 | 2020-07-30 |
| 1760046270 | Adriana Nicole Jones | Counselor | 1845 Grandstand Place, Elgin, IL 60123 | 2019-04-30 |
| 1437694544 | Jessica Martinez | Social Worker | 1845 Grandstand Place, Elgin, IL 60123 | 2016-12-28 |
| 1063860054 | Bridgette Alexandra Montgomery | Social Worker | 1845 Grandstand Place, Elgin, IL 60123-4983 | 2016-05-31 |
| 1275900235 | Lindsay Christine Gerhardt | Case Manager/Care Coordinator | 1845 Grandstand Place, Elgin, IL 60123 | 2015-08-26 |
| 1841623758 | Noelle J Dodge | Counselor | 1845 Grandstand Place, Elgin, IL 60123-2052 | 2013-08-14 |
| 1164794657 | Patricia Rice | Counselor | 1845 Grandstand Place, Elgin, IL 60123 | 2012-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625736 | Edna Lopez | Social Worker | 1140 N. Mclean Blvd #1, Elgin, IL 60123 | 2019-08-22 |
| 1003472259 | Katelyn Lee O'connell | Counselor | 695 S. Sate Street, Elgin, IL 60123 | 2019-05-14 |
| 1598235152 | Katie Elizabeth Dwyer | Counselor | 695 S. State Street, Elgin, IL 60123 | 2018-11-27 |
| 1174002778 | James M Accetta | Counselor | 52 Surry Drive, Elgin, IL 60123 | 2018-08-14 |
| 1770086175 | Griswold Home Care | Adult Companion | 707 A Davis Road, Suite 203, Elgin, IL 60123 | 2018-03-12 |
| 1003315706 | Danielle Bryant | Nurse Practitioner | 745 Fletcher Dr Ste 101, Elgin, IL 60123 | 2018-02-08 |
| 1912421470 | Deborah Foshager | Counselor | 680 Shenandoah Trail, Elgin, IL 60123 | 2017-07-26 |
| 1760903470 | Miguel Camargo | Specialist/Technologist | 12 N Aldine St, Elgin, IL 60123 | 2017-07-03 |
| 1134658594 | David Sommer | Counselor | 1460 Umbdenstock Rd, Elgin, IL 60123 | 2017-06-08 |
| 1649719618 | Faheem Unisa Syed | Clinical Nurse Specialist | 1990 Larkin Ave., Elgin, IL 60123 | 2017-02-23 |
| Find all providers in zip 60123 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144876509 | A&j Counseling and Consulting Agency, LLC. | Counselor | 1502 Smyrna Rd, Elgin, SC 29045-8904 | 2019-08-12 |
| 1003472259 | Katelyn Lee O'connell | Counselor | 695 S. Sate Street, Elgin, IL 60123 | 2019-05-14 |
| 1770047821 | Suzanne Antoinette Favors | Counselor | Ecker Center for Mental Health, 1845 Grandstand Place, Elgin, IL 60123-4983 | 2019-01-23 |
| 1598235152 | Katie Elizabeth Dwyer | Counselor | 695 S. State Street, Elgin, IL 60123 | 2018-11-27 |
| 1790269710 | Randy Burage | Counselor | 430 Victoria Ln, Elgin, IL 60124-3838 | 2018-09-17 |
| 1174002778 | James M Accetta | Counselor | 52 Surry Drive, Elgin, IL 60123 | 2018-08-14 |
| 1720564156 | Clarity, Calm & Peace Behavioral Health Services, Inc. | Counselor | 164 Division Street, Suite 203, Elgin, IL 60120-5516 | 2018-07-18 |
| 1538650460 | Eve Ahrens | Counselor | 164 Division St Ste 502, Elgin, IL 60120-5531 | 2018-05-26 |
| 1396262333 | Chrissy Senior | Counselor | 620 Wing St Ste 3, Elgin, IL 60123-2800 | 2017-08-29 |
| 1912421470 | Deborah Foshager | Counselor | 680 Shenandoah Trail, Elgin, IL 60123 | 2017-07-26 |
| Find all providers in ELGIN | ||||
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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.