Revitalize Medical Center LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

REVITALIZE MEDICAL CENTER LLC

Practice address

2550 Compass Rd Unit Ab
Glenview, IL 60026-1610

Phone

(847) 834-4018

Fax

(847) 834-4944

NPI assigned

Sep 5, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Sheetal K Decaria, MDNPI 1649569534

Title

Owner

Phone

(847) 834-4018

Specialties & licenses 1

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.

• Sheetal K Decaria, MD

  • Interventional Pain Medicine Physician
  • Glenview, IL
  • NPI 1649569534
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1467934414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 COMPASS RD UNIT AB",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261610",
            "telephone_number": "847-834-4018",
            "fax_number": "847-834-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 COMPASS RD UNIT AB",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261610",
            "telephone_number": "847-834-4018",
            "fax_number": "847-834-4944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602023328",
            "country_code": "US",
            "telephone_number": "847-834-4018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVITALIZE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-05",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "DECARIA",
        "authorized_official_first_name": "SHEETAL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-834-4018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Scott Repa, ATC
• Reserve Dermatology & Aesthetics PLLC
• Respite Care/Care in the Home, Inc.
• Resurrection Services
• John Mark Revis, MD
• Revitalize Wellness Center
• Darsy N Reyes Martinez
• Rafael Concepcion Reyes, PT
• Alex D Reynish, PSY.D
• Kathleen A Reynolds, RN CDE

• Interventional Pain Medicine Physician in Glenview, IL
• Providers in Glenview, IL by specialty
• Interventional Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.