1. Home
  2. Directory
  3. Illinois
  4. Rockford
  5. Clinic Center
  6. NPI Profile

RENVIVA LLC
NPI 1962873919
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Rockford, IL

Active since October 16, 2015CLIA 14D2109674 · Waiver
1/5
Overall Rating
1235 N MULFORD RD, ROCKFORD, IL 61107(513) 673-5245(866) 352-4339 Get Directions Write a Review

NPPES record last updated: September 26, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Renviva Llc NPPES

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

RENVIVA LLC (NPI 1962873919) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Rockford, Illinois and active in the NPI registry since October 2015. The organization holds a CLIA Waiver certificate valid through February 28, 2028 and lists Sandra Diane Fritzsch, Member Manager, as its authorized official.

NPPES Registry Identity

NPI1962873919
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameRENVIVA LLC
Location Address1235 N MULFORD RDRockford, IL 61107-3879
Mailing Address1235 N Mulford RdRockford, IL 61107-3879 · (513) 673-5245 · Fax (866) 352-4333
Phone(513) 673-5245
Fax(866) 352-4339
Organization SubpartNo
Authorized OfficialSandra Diane FritzschMember Manager · (513) 673-5245
Enumeration DateOctober 16, 2015
Last NPPES UpdateSeptember 26, 2016
✔ NPI 1962873919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
1235 N MULFORD RD, Rockford, IL 61107
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2109674

Renviva LLC · Rockford, IL
Active · expires Feb 28, 2028
CLIA Number14D2109674
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateFebruary 28, 2026
Certificate Expiration DateFebruary 28, 2028
Laboratory DirectorFarhan Khan MD
Laboratory Phone(779) 423-1907
Laboratory LocationRenviva LLC1235 Cornerston Bldg, Mulford Rd, Rockford, IL 61107
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for Renviva, LLC (CMS certification number 142803), from CMS Care Compare.

Renviva, LLC

Dialysis facility · Rockford, IL
1/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
CMS Certification Number142803
ESRD NetworkNetwork 10
Medicare-Certified SinceAugust 8, 2016
Location1235 N. Mulford RoadRockford, IL 61107 · Winnebago County
Phone(779) 423-1254
Services Offered
Peritoneal dialysis Home hemodialysis training

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTOPHER A GREEN MD
Orthopaedic Surgery
1235 N MULFORD RD
ROCKFORD, IL 61107
Winnebago County (815) 398-7755
SCOTT JONES PT
Physical Medicine & Rehabilitation
1235 N MULFORD RD
ROCKFORD, IL 61107
Winnebago County (920) 451-8142
DAVID L MCCARTY MD
Orthopaedic Surgery
1235 N MULFORD RD, STE 100
ROCKFORD, IL 61107
Winnebago County (815) 484-9999
ORTHOPEDIC ASSOCIATES OF NORTHERN ILLINOIS, LLC
Orthopaedic Surgery
1235 N MULFORD RD, SUITE 100
ROCKFORD, IL 61107
Winnebago County (815) 484-9999
ORTHOPAEDIC & ARTHRITIS CLINIC OF ROCKFORD LTD
Orthopaedic Surgery
1235 N MULFORD RD
ROCKFORD, IL 61107
Winnebago County (815) 398-7755
DONALD H HOLDER MD
Orthopaedic Surgery
1235 N MULFORD RD
ROCKFORD, IL 61107
Winnebago County (815) 637-8637
ADVANCED ALLERGY & ENT, LLC
Otolaryngology
1235 N MULFORD RD, SUITE 100
ROCKFORD, IL 61107
Winnebago County (815) 484-9900
ADVANCED FACIAL PLASTICS & MOHS
Dermatology (MOHS-Micrographic Surgery)
1235 N MULFORD RD, SUITE 100
ROCKFORD, IL 61107
Winnebago County (815) 484-9900

Frequently Asked Questions

What is RENVIVA LLC's NPI number?

The NPI number assigned to this healthcare provider is 1962873919, enumerated as an "organization" on October 16, 2015.

Where is the provider located?

The provider is located at 1235 N MULFORD RD ROCKFORD, IL 61107 and the phone number is (513) 673-5245.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QE0700X and a focus in End-Stage Renal Disease (ESRD) Treatment.

What insurance does RENVIVA LLC accept?

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health. Please consult your insurance carrier or call the provider to verify.