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HEALTH AND RENEWAL INTERNAL MEDICINE SC NPI 1235467903


NPI Information

NPI: 1235467903
Provider Name: HEALTH AND RENEWAL INTERNAL MEDICINE SC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
2850 W 95TH ST
SUITE 301
EVERGREEN PARK, IL
ZIP 60805
Phone: (708) 389-2200
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HEALTH AND RENEWAL INTERNAL MEDICINE SC is a medical specialty clinic center in Evergreen Park, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). HEALTH AND RENEWAL INTERNAL MEDICINE SC NPI is 1235467903. The provider is registered as an organization entity type.

The provider's business location address is:

2850 W 95TH ST
SUITE 301
EVERGREEN PARK, IL
ZIP 60805-735
Phone: (708) 389-2200
Fax: (708) 389-2211

The provider's authorized official is Dolores Louise Dixon-grevious .
The authorized official title is President and has the following contact phone number (312) 850-3855.

The enumeration date for this NPI number is 11/18/2009 and was last updated on 11/18/2009.


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
1261QM2500XClinic/CenterMedical Specialty01060010AINDIANANo
2261QM2500XClinic/CenterMedical Specialty036100552ILLINOISYes

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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