Provider Demographics
NPI:1760981138
Name:REJUVENATE HEALTH INC.
Entity Type:Organization
Organization Name:REJUVENATE HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAQIR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-400-4140
Mailing Address - Street 1:534 CHESTNUT ST STE 120
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3175
Mailing Address - Country:US
Mailing Address - Phone:630-400-4140
Mailing Address - Fax:630-655-7425
Practice Address - Street 1:534 CHESTNUT ST STE 120
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3175
Practice Address - Country:US
Practice Address - Phone:630-400-4140
Practice Address - Fax:630-655-7425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012309261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center