HEALTH AND RENEWAL INTERNAL MEDICINE SC (NPI# 1235467903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235467903 |
| Entity Type | Organization |
| Organization Name | HEALTH AND RENEWAL INTERNAL MEDICINE SC |
| Practice Address |
2850 W 95th St Suite 301 Evergreen Park IL 60805-2735 |
| Mailing Address |
849 W Ohio St Unit 1 Chicago IL 60642-6982 |
| Practice Telephone | 7083892200 |
| Practice Fax Number | 7083892211 |
| Mailing Telephone | 3128503855 |
| Mailing Fax Number | 3128503856 |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2009-11-18 |
| Authorized Official Name | DR. DOLORES LOUISE DIXON-GREVIOUS (PRESIDENT) |
| Authorized Official Telephone | 3128503855 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
01060010A | IN | Ambulatory Health Care Facilities |
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
036100552 | IL | Ambulatory Health Care Facilities |
| Street Address |
2850 W 95TH ST SUITE 301 |
| City | EVERGREEN PARK |
| State | IL |
| Zip Code | 60805-2735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598760480 | Michael R Fiorucci | Surgery | 2850 W 95th St, Suite 306, Evergreen Park, IL 60805-2735 | 2005-06-16 |
| 1295197697 | Shina Keaonis Gordon | Nurse Practitioner | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2016-03-24 |
| 1659757888 | Yvonne Oldaker | Advanced Practice Midwife | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2015-08-11 |
| 1386037984 | Leslie Kelly | Nurse Practitioner | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2015-03-06 |
| 1558754291 | Gina Marie Chigaros | Counselor | 2850 W 95th St, Mary Potter Pavilion Suite 403, Evergreen Park, IL 60805-2735 | 2015-03-05 |
| 1629487806 | Deon Shere Cooper | Registered Nurse | 2850 W 95th St, Suite 301, Evergreen Park, IL 60805-2735 | 2014-08-12 |
| 1750621884 | Cynthia M Hayes | Clinical Nurse Specialist | 2850 W 95th St, Evergreen Park, IL 60805-2735 | 2013-02-27 |
| 1336488212 | The Cardiology Group | Clinical Nurse Specialist | 2850 W 95th St, Suite 305, Evergreen Park, IL 60805-2735 | 2013-02-12 |
| 1255608808 | Kunhunn Vellody Md | Clinic/Center | 2850 W 95th St, Suite 201, Evergreen Park, IL 60805-2735 | 2011-11-28 |
| 1457649121 | Ryan Kukor | Internal Medicine | 2850 W 95th St, Suite 102, Evergreen Park, IL 60805-2735 | 2011-07-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| 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). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144400474 | Oliver Drabkin M.d. S.c. | Clinic/Center | 3900 W 95th St, Evergreen Park, IL 60805-1922 | 2007-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295351062 | Sara M Gotheridge Md LLC | Clinic/Center | 630 Davis St Ste 301, Evanston, IL 60201-4480 | 2020-06-17 |
| 1407484645 | Macumber Medical Ltd | Clinic/Center | 3114 W Irving Park Rd Ste 1w, Chicago, IL 60618-3435 | 2020-04-01 |
| 1477181782 | Embassy Studios North | Clinic/Center | 6455 N Cicero Ave, Lincolnwood, IL 60712-3407 | 2020-03-31 |
| 1689226318 | Midway Spine and Joint Pain Physicians | Clinic/Center | 5720 S Pulaski Rd, Chicago, IL 60629-4435 | 2019-07-12 |
| 1215598891 | Vero Clinics | Clinic/Center | 1192 E Pershing Rd, Decatur, IL 62526-4753 | 2019-06-25 |
| 1497215933 | Activate Healthcare | Clinic/Center | 2010 N Damen Ave Unit F, Chicago, IL 60647-3286 | 2019-03-21 |
| 1033699467 | Healthpointe Medical Center Sc | Clinic/Center | 530 Fullerton Rd Ste B, Swansea, IL 62226-2970 | 2018-08-15 |
| 1740794882 | Highland Park Cvs, L.L.C. | Clinic/Center | 72 Airport Plz, Bethalto, IL 62010-1774 | 2017-11-28 |
| 1447764014 | Dr Courtney Drendel Inc | Clinic/Center | 515 Hamilton St # 100, Geneva, IL 60134-2138 | 2017-11-19 |
| 1699206599 | David M Conner M.d. | Clinic/Center | 9 Executive Woods Ct Ste 2, Swansea, IL 62226-2016 | 2017-03-22 |
| Find all providers with the same taxonomy | ||||
| City | EVERGREEN PARK |
| Zip Code | 60805 |
Please comment or provide details below to improve the information on HEALTH AND RENEWAL INTERNAL MEDICINE SC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.