Provider Demographics
NPI:1629139092
Name:NEREN, STEVEN HARRY (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:HARRY
Last Name:NEREN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 WHITE CLOUD DRIVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076
Mailing Address - Country:US
Mailing Address - Phone:847-226-1008
Mailing Address - Fax:847-982-0267
Practice Address - Street 1:3915 WHITE CLOUD DRIVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076
Practice Address - Country:US
Practice Address - Phone:847-226-1008
Practice Address - Fax:847-982-0267
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071003875103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001608293OtherBCBS
IL391200Medicare ID - Type Unspecified