Healthcare Provider Details

I. General information

NPI: 1871242420
Provider Name (Legal Business Name): NENE TAKAHASHI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W 22ND ST STE 260
OAK BROOK IL
60523-1947
US

IV. Provider business mailing address

600 W 22ND ST STE 260
OAK BROOK IL
60523-1947
US

V. Phone/Fax

Practice location:
  • Phone: 331-291-8522
  • Fax: 872-345-0298
Mailing address:
  • Phone: 331-291-8522
  • Fax: 872-345-0298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036172044
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: