| Renacer Latino Inc. | |
|
620 Washington St Waukegan IL 60085-5421 | |
| (847) 336-7302 | |
| Not Available |
| Full Name | Renacer Latino Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 620 Washington St, Waukegan, Illinois |
| Authorized Official Name and Position | Luz R Gvero (EXECTIVE DIRECTOR) |
| Authorized Official Contact | 8473367302 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renacer Latino Inc. 620 Washington St Waukegan IL 60085-5421 Ph: (847) 336-7302 | Renacer Latino Inc. 620 Washington St Waukegan IL 60085-5421 Ph: (847) 336-7302 |
| NPI Number | 1801072970 |
|---|---|
| Provider Enumeration Date | 01/18/2008 |
| Last Update Date | 01/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801072970 | NPI | - | NPPES |
| 04932522 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 897 (Illinois) | Primary |
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