| Revive & Renew | |
|
716 S Main St Lombard IL 60148-3344 | |
| (815) 573-8464 | |
| Not Available |
| Full Name | Revive & Renew |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 716 S Main St, Lombard, Illinois |
| Authorized Official Name and Position | Stephanie Wascher (ADVANCED PRACTICE NURSE) |
| Authorized Official Contact | 8155738464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive & Renew 1s122 Eliot Ln Villa Park IL 60181-3710 Ph: (815) 573-8464 | Revive & Renew 716 S Main St Lombard IL 60148-3344 Ph: (815) 573-8464 |
| NPI Number | 1124902994 |
|---|---|
| Provider Enumeration Date | 08/04/2025 |
| Last Update Date | 08/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124902994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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