Revive & Renew

NPI #1124902994 in Lombard, Illinois

Provider Information

NPI Number
1124902994
Entity Type
Organization
Organization Name
Revive & Renew
Primary Specialty
Clinic/Center - Primary Care
Enumeration Date
Aug 4, 2025
Last Updated
Aug 4, 2025

Practice Location

Address
716 S MAIN ST
ZIP Code
60148-3344
Phone
(815) 573-8464

Authorized Official

Name
STEPHANIE WASCHER, APN
Title
ADVANCED PRACTICE NURSE
Phone
(815) 573-8464

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Primary CarePrimary Care

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