Renovena Health Inc

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

RENOVENA HEALTH INC

Practice address

4320 Winfield Rd Ste 200
Warrenville, IL 60555-4023

Phone

(630) 364-1316

Fax

(708) 377-6558

NPI assigned

May 7, 2020

Last updated

Jun 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christine Wanyana, APN-C

Title

Nurse Practitioner

Phone

(630) 364-1316

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591401600000",
    "number": "1740802214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 WINFIELD RD STE 200",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554023",
            "telephone_number": "630-364-1316",
            "fax_number": "708-377-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 WINFIELD RD STE 200",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554023",
            "telephone_number": "630-364-1316",
            "fax_number": "708-377-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENOVENA HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-06-06",
        "certification_date": "2020-06-06",
        "status": "A",
        "authorized_official_last_name": "WANYANA",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "630-364-1316",
        "authorized_official_credential": "APN-C"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "manager@renovena.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "4320 Winfield Rd Ste 200",
            "city": "Warrenville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605554023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Geriatric Medicine (Internal Medicine) Physician in Warrenville, IL
• Providers in Warrenville, IL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2020; 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.