RENVIVA LLC (NPI# 1962873919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962873919 |
| Entity Type | Organization |
| Organization Name | RENVIVA LLC |
| Practice Address |
1235 N Mulford Rd Rockford IL 61107-3879 |
| Practice Telephone | 5136735245 |
| Practice Fax Number | 8663524339 |
| Mailing Telephone | 5136735245 |
| Mailing Fax Number | 8663524333 |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2016-09-26 |
| Authorized Official Name | MS. SANDRA DIANE FRITZSCH (MEMBER MANAGER) |
| Authorized Official Telephone | 5136735245 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Street Address |
1235 N MULFORD RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-3879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821091075 | Susan M Fowell | Ophthalmology | 1235 N Mulford Rd, Suite 100, Rockford, IL 61107-3879 | 2005-05-23 |
| 1164875852 | Bryn Maxine Byers Krause | Nurse Practitioner | 1235 N Mulford Rd, Suite 205, Rockford, IL 61107-3879 | 2016-07-18 |
| 1306211198 | Christine Lenox | Counselor | 1235 N Mulford Rd, Suite 200, Rockford, IL 61107-3879 | 2015-12-06 |
| 1578971487 | Northern Illinois Trauma Regional Orthopaedics, LLC | Orthopaedic Surgery | 1235 N Mulford Rd, Suite 103, Rockford, IL 61107-3879 | 2014-07-24 |
| 1598053571 | Stephanie Jo Drake | Physical Therapy Assistant | 1235 N Mulford Rd, Rockford, IL 61107-3879 | 2011-07-12 |
| 1932437290 | Surgical Services of Illinois, Sc | Dermatology | 1235 N Mulford Rd, Ste. 205, Rockford, IL 61107-3879 | 2009-11-25 |
| 1154576221 | Tanya J. Munger | Registered Nurse | 1235 N Mulford Rd, Suite 222, Rockford, IL 61107-3879 | 2008-11-17 |
| 1376714600 | Laura Koch | Clinical Nurse Specialist | 1235 N Mulford Rd, Suite 200, Rockford, IL 61107-3879 | 2008-03-14 |
| 1669640504 | Todd D Alexander Md Sc | Neurological Surgery | 1235 N Mulford Rd, Suite 210, Rockford, IL 61107-3879 | 2008-02-13 |
| 1942483664 | Northern Illinois Retina Ltd | Ophthalmology | 1235 N Mulford Rd, Suite 100, Rockford, IL 61107-3879 | 2007-12-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871092510 | Dialysis of Northern Illinois LLC | Clinic/Center | 3927 W Riverside Blvd, Rockford, IL 61101-9507 | 2018-02-08 |
| 1033658349 | Machesney Bay Dialysis, LLC | Clinic/Center | 198 N Springfield Ave, Rockford, IL 61101-5086 | 2017-02-20 |
| 1518276955 | Total Renal Care Inc | Clinic/Center | 1302 E State St, Rockford, IL 61104-2228 | 2010-10-04 |
| 1477647139 | Rai Care Centers of Michigan I, LLC | Clinic/Center | 311 Rockford Park Dr Ne, Rockford, MI 49341-7817 | 2006-10-03 |
| 1154436905 | Dialysis Centers of America - Illinois, Inc. | Clinic/Center | 1302 E. State Street, Rockford, IL 61112-1061 | 2006-08-20 |
| 1285694729 | Renal Treatment Centers Illinois Inc | Clinic/Center | 417 Ware Ave, Rockford, IL 61107-6413 | 2006-03-27 |
| 1003875402 | Dialysis of Northern Illinois LLC | Clinic/Center | 622 Roxbury Rd, Rockford, IL 61107-5089 | 2006-03-23 |
| 1235198235 | Renal Treatment Centers Illinois Inc | Clinic/Center | 3339 N Rockton Ave, Rockford, IL 61103-2839 | 2006-03-20 |
| 1922410125 | Home Dialysis Services Rockford LLC | Clinic/Center | 6940 Villagreen Vw, Rockford, IL 61107-5605 | 2014-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550486 | Home Dialysis & Kidney Care Limited | Clinic/Center | 1252 Ogden Ave Ste D, Downers Grove, IL 60515-2740 | 2020-08-28 |
| 1922619824 | Dialysis Care Center Evergreen Park LLC | Clinic/Center | 9834 S Kedzie Ave, Evergreen Park, IL 60805-3135 | 2020-08-13 |
| 1558970525 | Concerto Massachusetts LLC | Clinic/Center | 4600 W Touhy Ave Ste 100, Lincolnwood, IL 60712-1606 | 2020-07-27 |
| 1629697917 | East Oaks Dialysis LLC | Clinic/Center | 2950 W 26th St, Chicago, IL 60623 | 2020-04-16 |
| 1376162735 | Hopkinton Dialysis LLC | Clinic/Center | 6001 W Ogden Ave, Cicero, IL 60804-3739 | 2020-04-15 |
| 1710511399 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 1946 Grand Avenue, Granite City, IL 62040-4613 | 2020-02-24 |
| 1861026478 | Proctor Community Hospital | Clinic/Center | 5401 N Knoxville Ave Ste 104, Peoria, IL 61614-5021 | 2020-02-24 |
| 1033741608 | Fresenius Medical Care New Lenox, LLC | Clinic/Center | 662 Cedar Crossings Dr, New Lenox, IL 60451-5200 | 2020-02-11 |
| 1730725904 | Perryton Dialysis LLC | Clinic/Center | 8604 Woodward Ave, Woodridge, IL 60517-3171 | 2019-11-22 |
| 1124678529 | Dialyze Direct Il LLC | Clinic/Center | 410 S Heinlein Dr, Shelbyville, IL 62565-7800 | 2019-09-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on RENVIVA LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.