MEDICARE: RENEE BOZZI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1770064032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE BOZZI

Provider Business Mailing Address
First Line	:	11536 S CENTRAL PARK AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60655-3652
Country	:	US
Telephone Number	:	708-668-3394
Fax Number	:

Provider Business Practice Location Address
First Line	:	675 N NORTH CT STE 360
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-8131
Country	:	US
Telephone Number	:	630-733-1441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	08/24/2018

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Directions to “ RENEE BOZZI ” Practice Location

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