Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive & Renew

Organization Primary Care Clinic/Center · NPI 1124902994

Revive & Renew is a Primary Care Clinic/Center in Lombard, Illinois. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

716 S Main St
Lombard, IL 60148-3344
Phone: (815) 573-8464
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X

Record details

NPI number1124902994
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephanie Wascher — Advanced Practice Nurse · (815) 573-8464
NPI enumeratedAugust 4, 2025
Last updated in NPPESAugust 4, 2025
Certification dateAugust 4, 2025
Mailing address1s122 Eliot Ln, Villa Park, IL 60181-3710

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