Healthcare Provider Details

I. General information

NPI: 1144154097
Provider Name (Legal Business Name): RENEW YOU HEALTH & WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ASHLAND AVE STE 101
CHICAGO HEIGHTS IL
60411-3091
US

IV. Provider business mailing address

500 ASHLAND AVE STE 101
CHICAGO HEIGHTS IL
60411-3091
US

V. Phone/Fax

Practice location:
  • Phone: 708-351-0077
  • Fax:
Mailing address:
  • Phone: 708-351-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGELA Y MARTIN
Title or Position: NURSE PRACTITIONER
Credential: APRN
Phone: 708-351-0077