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REJUVENESSE NPI 1275846362


NPI Information

NPI: 1275846362
Provider Name: REJUVENESSE
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
5911 NORTHWEST HWY
SUITE 101
CRYSTAL LAKE, IL
ZIP 60014
Phone: (815) 788-1992
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REJUVENESSE is an internal medicine in Crystal Lake, IL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. REJUVENESSE NPI is 1275846362. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5911 NORTHWEST HWY
SUITE 101
CRYSTAL LAKE, IL
ZIP 60014-065
Phone: (815) 788-1992
Fax: (815) 788-1993

The provider's authorized official is Syed Waseem Haider .
The authorized official title is M.d. and has the following contact phone number (815) 788-1992.

The enumeration date for this NPI number is 7/19/2010 and was last updated on 7/19/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine036100063ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G93392MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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