Organization Active NPI

Renewal Rehab LLC

  • Occupational Therapist
  • Lincolnwood, IL
National Provider Identifier
1033460555
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
RENEWAL REHAB LLC
Practice address
7358 N Lincoln Ave Ste 160
Lincolnwood, IL 60712-1797
Phone
(847) 983-8750
NPI assigned
Sep 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eliezer Meystel
Title
Ceo
Phone
(847) 983-8750

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

7358 N Lincoln Ave Ste 160
Lincolnwood, IL 60712-1797

Mailing address

7358 N Lincoln Ave Ste 160
Lincolnwood, IL 60712-1797
Phone (847) 983-8750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150716001778 IL Part B Supplier - Clinic/Group Practice 2062725237 Practice locations: Lincolnwood, IL

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Belmont ManorSaint Clairsville, OH, CCN 366190 Skilled nursing facility Adp of the SNF Jan 1, 2025
Villa Vista Royale, LLCSteubenville, OH, CCN 366416 Skilled nursing facility Adp of the SNF Jan 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1033460555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7358 N LINCOLN AVE STE 160",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121797",
            "telephone_number": "847-983-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7358 N LINCOLN AVE STE 160",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121797",
            "telephone_number": "847-983-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWAL REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-24",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "MEYSTEL",
        "authorized_official_first_name": "ELIEZER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-983-8750"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnwood, IL

Sources for this page

Verify at the official NPI Registry.