Healthcare Provider Details

I. General information

NPI: 1427975416
Provider Name (Legal Business Name): MOLLY BERENDT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1330 SHERMER RD STE 232
NORTHBROOK IL
60062-4539
US

IV. Provider business mailing address

2533 OAK DR
WEST DUNDEE IL
60118-1517
US

V. Phone/Fax

Practice location:
  • Phone: 847-750-5881
  • Fax:
Mailing address:
  • Phone: 847-531-3494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150112780
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: