Individual provider Active NPI

Marco Jolly Renzi

  • Clinical Social Worker
  • Chicago, IL
National Provider Identifier
1861028474
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149024621 Issued in IL
Practice address
820 N Orleans St Ste 350
Chicago, IL 60610-3145
Phone
(312) 809-0298
NPI assigned
Mar 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149024621 IL Primary

Addresses

Primary practice location

820 N Orleans St Ste 350
Chicago, IL 60610-3145

Mailing address

1333 N Kingsbury St Ste 303
Chicago, IL 60642-2687
Phone (312) 809-0298

Other practice location 1

4770 Baseline Rd Ste 200
Boulder, CO 80303-2668
Phone (312) 809-0298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149024621ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wildflower Center for Emotional Health PLLC Clinical CurrentSince Feb 13, 2022 Accepting new patients

Locations

1333 N Kingsbury St
Ste 303
Chicago, IL 60642
Phone (312) 809-0298

820 N Orleans St
Ste 350
Chicago, IL 60610
Phone (312) 809-0298

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1861028474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 N KINGSBURY ST STE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606422687",
            "telephone_number": "312-809-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 N ORLEANS ST STE 350",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606103145",
            "telephone_number": "312-809-0298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4770 Baseline Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803032668",
            "country_code": "US",
            "telephone_number": "312-809-0298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENZI",
        "first_name": "MARCO",
        "middle_name": "JOLLY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-15",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149024621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.