Provider Demographics
NPI:1184990160
Name:MIDWEST BEHAVIORAL RISK MANAGEMENT, P.C.
Entity type:Organization
Organization Name:MIDWEST BEHAVIORAL RISK MANAGEMENT, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BRENZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-344-7472
Mailing Address - Street 1:869 E SCHAUMBURG RD
Mailing Address - Street 2:SUITE 252
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-3654
Mailing Address - Country:US
Mailing Address - Phone:847-344-7472
Mailing Address - Fax:224-653-9181
Practice Address - Street 1:869 E SCHAUMBURG RD
Practice Address - Street 2:SUITE 252
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-3654
Practice Address - Country:US
Practice Address - Phone:847-344-7472
Practice Address - Fax:224-653-9181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-24
Last Update Date:2012-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007267103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty