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Organization

HEALTH AND RENEWAL INTERNAL MEDICINE SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DOLORES LOUISE DIXON-GREVIOUS MD (PRESIDENT)
(312) 850-3855
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
01060010A
IN
261QM2500X
Medical Specialty Clinic/Center
Primary
036100552
IL

Other

Enumeration date
11/18/2009
Last updated
11/18/2009
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