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General NPI Number Information
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NPI Number | 1942908694
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Entity Type | Organization
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Legal Business Name | REJUVEINATE OF ILLINOIS PLLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 4711 GOLF RD STE 100
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City | SKOKIE
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State | IL
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Zip | 60076-1239
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Country | US
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Telephone | 443-414-8201
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Fax | 973-860-0857
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Provider Business Mailing Address
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Address Line | 28 HEIGHTS RD
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City | CLIFTON
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State | NJ
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Zip | 07012-1215
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Country | US
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Telephone | 443-414-8201
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABRAHAM LEHMAN
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Credential | MD
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Telephone | 443-414-8201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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