=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528995743
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EVERPATH THERAPY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2026
-----------------------------------------------------
Last Update Date | 05/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 SKOKIE BLVD STE 215
-----------------------------------------------------
City | NORTHBROOK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60062-4043
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-294-5557
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 332 NOTTINGHAM AVE
-----------------------------------------------------
City | GLENVIEW
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60025-5022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-294-5557
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/THERAPIST
-----------------------------------------------------
Name | CAROLYN NAM
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 773-294-5557
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------