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General NPI Number Information
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NPI Number | 1609000462
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Entity Type | Organization
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Legal Business Name | RENEE B WRIGHT PC
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Dates
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Enumeration Date | 05/08/2009
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 636 CHURCH ST STE 515
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City | EVANSTON
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State | IL
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Zip | 60201-4581
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Country | US
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Telephone | 847-904-1220
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Fax |
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Provider Business Mailing Address
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Address Line | 2830 HARRISON ST
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City | EVANSTON
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State | IL
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Zip | 60201-1218
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Country | US
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Telephone | 847-207-1065
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RENEE B WRIGHT
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Credential | MSW, LCSW
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Telephone | 847-904-1220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149-007117
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License Number State | IL
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