Provider Demographics
NPI:1063720050
Name:RENZ, CHRISTINE ANN (LAC)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ANN
Last Name:RENZ
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:900 SKOKIE BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4012
Mailing Address - Country:US
Mailing Address - Phone:847-272-8120
Mailing Address - Fax:847-272-8125
Practice Address - Street 1:900 SKOKIE BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4012
Practice Address - Country:US
Practice Address - Phone:847-272-8120
Practice Address - Fax:847-272-8125
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000856171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist