Center for Health Renewal and Longevity LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

209002058 Issued in IL

Legal business name

CENTER FOR HEALTH RENEWAL AND LONGEVITY LLC

Practice address

201 W Springfield Ave
Suite 206
Champaign, IL 61820-4834

Phone

(217) 955-9554

NPI assigned

Mar 10, 2009

Organization subpart

No

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

Authorized official

Name

Kristy Krueger

Title

Managed Care Coordinator

Phone

(217) 784-2364

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508803200000",
    "number": "1881835577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W SPRINGFIELD AVE",
            "address_2": "SUITE 206",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204834",
            "telephone_number": "217-955-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W SPRINGFIELD AVE",
            "address_2": "SUITE 206",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204834",
            "telephone_number": "217-955-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR HEALTH RENEWAL AND LONGEVITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-10",
        "last_updated": "2017-10-24",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "MANAGED CARE COORDINATOR",
        "authorized_official_telephone_number": "217-784-2364"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "209002058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Cavazos, PMHNP-BC
• Laura Cayce, D.C.
• CCM Champaign County Mobility LL
• Cindy San Esteban Cecilio, RPT
• Siegfred T. Celis
• Central Illinois Diagnostic Imaging Center, LLC
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• Central State Chiropractic & Rehabilitation
• Litzi Ceron-Conde

• Medical Specialty Clinic/Center in Champaign, IL
• Providers in Champaign, 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 Oct 24, 2017; 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.