Healthcare Provider Details

I. General information

NPI: 1457256653
Provider Name (Legal Business Name): RELINQUISH AND RENEWED PSYCHIATRY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1765 E 55T ST APT E6
CHICAGO IL
60615
US

IV. Provider business mailing address

1765 E 55T ST APT E6
CHICAGO IL
60615
US

V. Phone/Fax

Practice location:
  • Phone: 708-769-0964
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. SHARRON WILLIAMS
Title or Position: CEO
Credential: PMHNP
Phone: 708-769-0964