NPI Code Details Logo

NPI 1407660293

NPI 1407660293 : SERENE PSYCHIATRY PLLC : HOFFMAN ESTATES, IL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1407660293
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    SERENE PSYCHIATRY PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/03/2025
-----------------------------------------------------
    Last Update Date     |    02/24/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1650 MOON LAKE BLVD 
-----------------------------------------------------
    City                 |    HOFFMAN ESTATES
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60169-1010
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    847-450-0222
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2300 N BARRINGTON RD STE 400 
-----------------------------------------------------
    City                 |    HOFFMAN ESTATES
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60169-2036
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    847-450-0222
-----------------------------------------------------
    Fax                  |    847-450-6575
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     SHAUN  WOOD 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    847-450-0222
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    2084P0800X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatry Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.