Healthcare Provider Details

I. General information

NPI: 1023296498
Provider Name (Legal Business Name): RENEE IRENE WOHLERT MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 10/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 S WILKE RD SUITE # 232
ARLINGTON HEIGHTS IL
60005-1533
US

IV. Provider business mailing address

121 S WILKE RD STE 101
ARLINGTON HEIGHTS IL
60005-1524
US

V. Phone/Fax

Practice location:
  • Phone: 847-686-3456
  • Fax:
Mailing address:
  • Phone: 847-686-3456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180010997
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: