Organization
THE RENAISSANCE CENTER I
Active
Other names
TRC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY L WEEMS PSY.D. (CHIEF EXECUTIVE OFFICER)
(773) 671-0466
Entity
Organization
Contact information
Practice address
1337 S INDIANA PKWY, CHICAGO, IL 60605-2619
(773) 671-0466
(312) 945-3750
Mailing address
430 E 162ND ST, SUITE 492, SOUTH HOLLAND, IL 60473-2258
(773) 671-0466
(312) 945-3750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
122300000X
Dentist
—
—
133V00000X
Registered Dietitian
—
—
152W00000X
Optometrist
—
—
163W00000X
Registered Nurse
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
02/01/2011
Last updated
02/01/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us