| Revival Therapy, P.c. | |
|
330 W. Terra Cotta Ave. Suite A Crystal Lake IL 60014 | |
| (815) 382-9691 | |
| (815) 800-0670 |
| Full Name | Revival Therapy, P.c. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 330 W. Terra Cotta Ave., Crystal Lake, Illinois |
| Authorized Official Name and Position | Sara Lemke (CEO/PRACTICE OWNER) |
| Authorized Official Contact | 8154516585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revival Therapy, P.c. 330 W. Terra Cotta Ave. Suite A Crystal Lake IL 60014 Ph: (815) 382-9691 | Revival Therapy, P.c. 330 W. Terra Cotta Ave. Suite A Crystal Lake IL 60014 Ph: (815) 382-9691 |
| NPI Number | 1376150896 |
|---|---|
| Provider Enumeration Date | 09/29/2020 |
| Last Update Date | 08/09/2024 |
| Certification Date | 02/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376150896 | NPI | - | NPPES |
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