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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