MEDICARE: DR. DELILAH ANN RENEGAR D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor	038-006687	IL
2	111NI0900X	Internist Chiropractor	038-006687	IL
3	111NI0900X	Internist Chiropractor	038006687	IL

General Provider Information

NPI Number	:	1902914989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DELILAH ANN RENEGAR D.C.

Provider Business Mailing Address
First Line	:	4555 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2102
Country	:	US
Telephone Number	:	630-561-9696
Fax Number	:

Provider Business Practice Location Address
First Line	:	4082 RIVER RDG
Second Line	:
City	:	SANDWICH
State	:	IL
Zip	:	60548-6905
Country	:	US
Telephone Number	:	630-479-9355
Fax Number	:	815-786-7477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	07/23/2025

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