Revive & Renew

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

REVIVE & RENEW

Practice address

716 S Main St
Lombard, IL 60148-3344

Phone

(815) 573-8464

NPI assigned

Aug 4, 2025

Organization subpart

No

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

Authorized official

Name

Stephanie Wascher, APNNPI 1760149900

Title

Advanced Practice Nurse

Phone

(815) 573-8464

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Stephanie Wascher, APRN

  • Nurse Practitioner
  • River Forest, IL
  • NPI 1760149900
  NPD Authorized official

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1124902994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S122 ELIOT LN",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601813710",
            "telephone_number": "815-573-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 S MAIN ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601483344",
            "telephone_number": "815-573-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE & RENEW",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "WASCHER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "ADVANCED PRACTICE NURSE",
        "authorized_official_telephone_number": "815-573-8464",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reliable Medical Services Inc
• Renovo Health Inc
• Kristen Restaino, PT
• Restore Change LLC
• Retina Center of Chicago PLLC
• Nicholas Rex, DMD
• Elizabeth Reynolds
• Kaylee Rose Reynolds
• Lindsey Reynolds, PT
• Stephanie Marie Reynolds, RDH

• Primary Care Clinic/Center in Lombard, IL
• Providers in Lombard, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.