Healthcare Provider Details

I. General information

NPI: 1578589750
Provider Name (Legal Business Name): CLAUDIA P WELKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 REVERE DR SUITE 100
NORTHBROOK IL
60062-1563
US

IV. Provider business mailing address

60 REVERE DR SUITE 100
NORTHBROOK IL
60062-1563
US

V. Phone/Fax

Practice location:
  • Phone: 224-306-1879
  • Fax: 224-306-1878
Mailing address:
  • Phone: 224-306-1879
  • Fax: 224-306-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number3059-320
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101278592
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberT8079
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD94237
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036-110449
License Number StateIL
# 6
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number036110449
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: