Healthcare Provider Details

I. General information

NPI: 1609483346
Provider Name (Legal Business Name): RENE M NEKIC LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2020
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 RAVINE WAY STE 600
GLENVIEW IL
60025-7615
US

IV. Provider business mailing address

2400 RAVINE WAY STE 600
GLENVIEW IL
60025-7615
US

V. Phone/Fax

Practice location:
  • Phone: 847-730-3042
  • Fax:
Mailing address:
  • Phone: 847-730-3042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number149022249
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: