NPIMap

Organization Active NPI

Renaissance Medical Group

  • Specialist
  • Oak Lawn, IL
National Provider Identifier
1992867311
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
RENAISSANCE MEDICAL GROUP
Practice address
4440 W 95TH St
Room 250 North
Oak Lawn, IL 60453-2600
Phone
(708) 684-5722
Fax
(708) 684-1405
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas F Myers, MDNPI 1285608513
Title
President
Phone
(708) 684-5722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X IL Primary

Addresses

Primary practice location

4440 W 95TH St
Room 250 North
Oak Lawn, IL 60453-2600

Mailing address

4440 W. 95TH Street
Room 250 North
Oak Lawn, IL 60453
Phone (708) 684-5722

National Provider Directory

National Provider Directory

Locations

4440 W 95th St
Ste 250N
Oak Lawn, IL 60453
Phone (708) 684-5722

4440 W 95th St
Rm 250
Oak Lawn, IL 60453
Phone (708) 684-5722

4440 W 95th St
Rm 250N
Oak Lawn, IL 60453
Phone (708) 684-5722

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992867311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 W. 95TH STREET",
            "address_2": "ROOM 250 NORTH",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-684-5722",
            "fax_number": "708-684-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "address_2": "ROOM 250 NORTH",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-5722",
            "fax_number": "708-684-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-684-5722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.