# HEALTH AND RENEWAL INTERNAL MEDICINE SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235467903
- **Authorized official:** DR. DOLORES LOUISE DIXON-GREVIOUS MD (PRESIDENT)
- **Authorized official phone:** (312) 850-3855

## Contact information

- **Practice address:** 2850 W 95TH ST, SUITE 301, EVERGREEN PARK, IL 60805-2735
- **Practice address phone:** (708) 389-2200
- **Practice address fax:** (708) 389-2211
- **Mailing address:** 849 W OHIO ST, UNIT 1, CHICAGO, IL 60642-6982
- **Mailing address phone:** (312) 850-3855
- **Mailing address fax:** (312) 850-3856

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 01060010A | IN | — |
| 261QM2500X | Medical Specialty Clinic/Center | 036100552 | IL | Yes |

## Other

- **Enumeration date:** 11/18/2009
- **Last updated:** 11/18/2009