Health and Renewal Internal Medicine SC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

036100552 Issued in IL

Legal business name

HEALTH AND RENEWAL INTERNAL MEDICINE SC

Practice address

2850 W 95TH St
Suite 301
Evergreen Park, IL 60805-2735

Phone

(708) 389-2200

Fax

(708) 389-2211

NPI assigned

Nov 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Dolores Louise Dixon-Grevious, MDNPI 1023089133

Title

President

Phone

(312) 850-3855

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dolores Dixon-Grevious, MD

  • Internal Medicine Physician
  • Evergreen Park, IL
  • NPI 1023089133
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1235467903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 W OHIO ST",
            "address_2": "UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606426982",
            "telephone_number": "312-850-3855",
            "fax_number": "312-850-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 301",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052735",
            "telephone_number": "708-389-2200",
            "fax_number": "708-389-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH AND RENEWAL INTERNAL MEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "DIXON-GREVIOUS",
        "authorized_official_first_name": "DOLORES",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-850-3855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "036100552",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IN",
            "license": "01060010A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmed Hassan, MS,PT
• Bilaal M Hassan, FNP-BC
• Mohamed Hassan, MHS,PT
• Hayat Home Medical Equipment
• Cynthia M Hayes, APN
• Health Is Wealth Wellness Center Inc
• Health Solutions at Home Inc
• Daniel K. Heenan, CRNA
• Becki Heimerle
• Ginny L Hendricks, M.D.

• Medical Specialty Clinic/Center in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.