Provider Demographics
NPI:1902673767
Name:RENEW HEALTH AND WELLNESS PC
Entity Type:Organization
Organization Name:RENEW HEALTH AND WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GENSLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-442-7175
Mailing Address - Street 1:1300 IROQUOIS AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8462
Mailing Address - Country:US
Mailing Address - Phone:630-442-7175
Mailing Address - Fax:630-631-0998
Practice Address - Street 1:1300 IROQUOIS AVE STE 150
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8462
Practice Address - Country:US
Practice Address - Phone:630-442-7175
Practice Address - Fax:630-631-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty