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Organization
CENTER FOR HEALTH RENEWAL AND LONGEVITY LLC
Active
Organization
CENTER FOR HEALTH RENEWAL AND LONGEVITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY KRUEGER (MANAGED CARE COORDINATOR)
(217) 784-2364
Entity
Organization
Contact information
Practice address
201 W SPRINGFIELD AVE, SUITE 206, CHAMPAIGN, IL 61820-4834
(217) 955-9554
Mailing address
201 W SPRINGFIELD AVE, SUITE 206, CHAMPAIGN, IL 61820-4834
(217) 955-9554
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
209002058
IL
Other
Enumeration date
03/10/2009
Last updated
10/24/2017
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