=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770725608
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RENANAH K. LEHNER, PHD, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2009
-----------------------------------------------------
Last Update Date | 03/24/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 233 E ERIE ST 713
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60611-2926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-743-9844
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2116 W BRADLEY PL
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60618-4910
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-742-9844
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. RENANAH K LEHNER
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 773-742-9844
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 071007160
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------