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RENOVARE HEALTHCARE SERVICES INC
NPI 1124712179
Nurse Practitioner - Psychiatric/Mental Health in Chicago, IL

Active since June 05, 2023
6160 N CICERO AVE STE 122, CHICAGO, IL 60646(773) 417-6071(224) 467-2170 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Renovare Healthcare Services Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RENOVARE HEALTHCARE SERVICES INC (NPI 1124712179) is a healthcare organization registered as a psychiatric/mental health in Chicago, Illinois and active in the NPI registry since June 2023. The organization lists Olumide A Oluwole, Owner, as its authorized official.

NPPES Registry Identity

NPI1124712179
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameRENOVARE HEALTHCARE SERVICES INC
Location Address6160 N CICERO AVE STE 122Chicago, IL 60646-4308
Mailing Address6818 N Lowell AveLincolnwood, IL 60712-4728 · (773) 417-6071 · Fax (224) 467-2170
Phone(773) 417-6071
Fax(224) 467-2170
Organization SubpartNo
Authorized OfficialOlumide A OluwoleOwner · (773) 392-1858
Enumeration DateJune 5, 2023
Last NPPES UpdateOctober 14, 2025
NPPES CertifiedOctober 14, 2025
✔ NPI 1124712179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
6160 N CICERO AVE STE 122, Chicago, IL 60646
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Renovare Healthcare Services Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Renovare Healthcare Services Inc, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Olumide Oluwole
Nurse Practitioner
NPI 1366982233
1441 BRANDING AVE STE 310
Downers Grove, IL 60515
(630) 829-1084
✔ PECOS✔ Accepts Medicare18 mi
Oluwakemi Udeogu, APN
Nurse Practitioner
NPI 1891187423
1441 BRANDING AVE #310
Downers Grove, IL 60515
(630) 829-1038
✔ PECOS✔ Accepts Medicare18 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Renovare Healthcare Services Inc's NPI number?

The NPI number for Renovare Healthcare Services Inc is 1124712179. It was assigned to this organization in the NPPES registry on June 5, 2023.

Where is Renovare Healthcare Services Inc located?

Renovare Healthcare Services Inc is located at 6160 N Cicero Ave Ste 122, Chicago, IL 60646. The listed phone number is (773) 417-6071.

What is Renovare Healthcare Services Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Renovare Healthcare Services Inc enrolled in Medicare?

Yes. Renovare Healthcare Services Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Renovare Healthcare Services Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Renovare Healthcare Services Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Renovare Healthcare Services Inc was last updated on October 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.