Healthcare Provider Details

I. General information

NPI: 1568397636
Provider Name (Legal Business Name): LAUREN WEIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 RAVINE WAY STE 100
GLENVIEW IL
60025-7621
US

IV. Provider business mailing address

3404 W BERTEAU AVE APT 2
CHICAGO IL
60618-2242
US

V. Phone/Fax

Practice location:
  • Phone: 224-548-8331
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: