Healthcare Provider Details

I. General information

NPI: 1144860222
Provider Name (Legal Business Name): LAUREN BRENNER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 W BYRON ST
CHICAGO IL
60613-2729
US

IV. Provider business mailing address

1620 N MARSHFIELD AVE APT 2F
CHICAGO IL
60622-8716
US

V. Phone/Fax

Practice location:
  • Phone: 773-244-0700
  • Fax:
Mailing address:
  • Phone: 224-688-2619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.024126
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.103397
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: