WICKER PARK RENAISSANCE
NPI 1619620853
Community/Behavioral Health in Chicago, IL

Q: What is Wicker Park Renaissance's NPI number?

The NPI number for Wicker Park Renaissance is 1619620853. It was assigned to this organization in the NPPES registry on January 28, 2022. The provider is also known as Historic Wicker Park.

Q: What is Wicker Park Renaissance's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Active since January 28, 2022

1527 N WICKER PARK AVE, CHICAGO, IL 60622(773) 645-8900 Get Directions Write a Review

NPPES record last updated: January 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Wicker Park Renaissance NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WICKER PARK RENAISSANCE (NPI 1619620853) is a healthcare organization registered as a community/behavioral health in Chicago, Illinois and active in the NPI registry since January 2022. The organization lists Michael Banghart, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1619620853

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameWICKER PARK RENAISSANCE

Location Address1527 N WICKER PARK AVEChicago, IL 60622-1996

Mailing Address2501 W Washington Blvd Ste 401Chicago, IL 60612-2127 · (773) 645-8900

Phone(773) 645-8900

Organization SubpartYesParent: Renaissance Social Services, Inc.

Authorized OfficialMichael BanghartExecutive Director · (773) 645-8900

Enumeration DateJanuary 28, 2022

NPPES CertifiedJanuary 28, 2022

✔ NPI 1619620853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Also ListedCase ManagementTaxonomy 251B00000X

1527 N WICKER PARK AVE, Chicago, IL 60622

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Other Names 1

Other NameHistoric Wicker Park

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wicker Park Renaissance's NPI number?

The NPI number for Wicker Park Renaissance is 1619620853. It was assigned to this organization in the NPPES registry on January 28, 2022. The provider is also known as Historic Wicker Park.

Where is Wicker Park Renaissance located?

Wicker Park Renaissance is located at 1527 N Wicker Park Ave, Chicago, IL 60622. The listed phone number is (773) 645-8900.

What is Wicker Park Renaissance's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Wicker Park Renaissance was last updated on January 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.