Provider Demographics
NPI:1760237457
Name:RENATA MENDEZ LLC
Entity Type:Organization
Organization Name:RENATA MENDEZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-341-7277
Mailing Address - Street 1:3 WHEATON CTR APT 505
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-4969
Mailing Address - Country:US
Mailing Address - Phone:815-341-7277
Mailing Address - Fax:
Practice Address - Street 1:3 WHEATON CTR APT 505
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-4969
Practice Address - Country:US
Practice Address - Phone:815-341-7277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty