| Renewal Comprehensive Services, Llc | |
|
5950 E Lincoln Ave Ste 300 Lisle IL 60532-3387 | |
| (312) 399-3077 | |
| Not Available |
| Full Name | Renewal Comprehensive Services, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5950 E Lincoln Ave Ste 300, Lisle, Illinois |
| Authorized Official Name and Position | Leslie Lewis Ford (PRACTICE OWNER) |
| Authorized Official Contact | 3123993077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renewal Comprehensive Services, Llc 1112 W Boughton Rd # 166 Bolingbrook IL 60440-1508 Ph: (312) 399-3077 | Renewal Comprehensive Services, Llc 5950 E Lincoln Ave Ste 300 Lisle IL 60532-3387 Ph: (312) 399-3077 |
| NPI Number | 1982961603 |
|---|---|
| Provider Enumeration Date | 04/19/2012 |
| Last Update Date | 10/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982961603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149011528 (Illinois) | Primary |
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