BOTKINS DIALYSIS LLC (NPI# 1134787864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134787864 |
| Entity Type | Organization |
| Organization Name | BOTKINS DIALYSIS LLC |
| Practice Address |
3119 N Lewis Ave Waukegan IL 60087-2254 |
| Mailing Address |
5200 Virginia Way Brentwood TN 37027-7569 |
| Practice Telephone | 8477828250 |
| Practice Fax Number | 8477828772 |
| Mailing Telephone | 6152383136 |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Beach Park Dialysis | Doing Business As Name - Organization |
| Street Address |
3119 N LEWIS AVE |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60087-2254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982268017 | Michael Donavan Wilson | Counselor | 200 North Lewis, Waukegan, IL 60087 | 2019-04-24 |
| 1114412160 | David B Fuentes | Specialist/Technologist | 2904 Wall Ave, Waukegan, IL 60087 | 2018-06-22 |
| 1578912713 | Fulton Family Dental, Ltd. | Dentist | 1308 Sunset Ave., Waukegan, IL 60087 | 2016-06-08 |
| 1902852825 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 3124 N Lewis Ave, Waukegan, IL 60087 | 2006-05-25 |
| 1396723565 | Daram H Reddy Md | Psychiatry & Neurology | 609 Greenwood Ave, Waukegan, IL 60087 | 2006-01-06 |
| 1609200328 | Rosa Margaret Uriostegui | Interpreter | 2117 Edgewood Rd, Waukegan, IL 60087-1442 | 2013-08-29 |
| 1518390871 | Mary Sol Enriquez | Developmental Therapist | 11307 W Edgewood Rd, Beach Park, IL 60087-1526 | 2013-08-09 |
| 1649894130 | Kelly M Ingram | Developmental Therapist | 38229 N North Ave, Beach Park, IL 60087-1662 | 2020-06-01 |
| 1467735209 | Kelly A. Holverson | Speech-Language Pathologist | 38286 N Geraghty Ave, Beach Park, IL 60087-1748 | 2011-09-27 |
| 1487669594 | Walgreen Co | Pharmacy | 39023 N Green Bay Rd, Beach Park, IL 60087-1978 | 2006-07-29 |
| Find all providers in zip 60087 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912292533 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 110 N West St, Waukegan, IL 60085-4330 | 2011-06-10 |
| 1417978156 | Isd Renal Inc | Clinic/Center | 3350 Grand Ave Ste 101, Waukegan, IL 60085-2206 | 2006-07-21 |
| 1659397859 | Isd Renal Inc | Clinic/Center | 3350 Grand Ave Ste 100, Waukegan, IL 60085-2206 | 2006-07-14 |
| 1205222197 | Fresenius Medical Care Lake County, LLC | Clinic/Center | 110 N West St, Waukegan, IL 60085-4330 | 2015-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550486 | Home Dialysis & Kidney Care Limited | Clinic/Center | 1252 Ogden Ave Ste D, Downers Grove, IL 60515-2740 | 2020-08-28 |
| 1922619824 | Dialysis Care Center Evergreen Park LLC | Clinic/Center | 9834 S Kedzie Ave, Evergreen Park, IL 60805-3135 | 2020-08-13 |
| 1558970525 | Concerto Massachusetts LLC | Clinic/Center | 4600 W Touhy Ave Ste 100, Lincolnwood, IL 60712-1606 | 2020-07-27 |
| 1629697917 | East Oaks Dialysis LLC | Clinic/Center | 2950 W 26th St, Chicago, IL 60623 | 2020-04-16 |
| 1376162735 | Hopkinton Dialysis LLC | Clinic/Center | 6001 W Ogden Ave, Cicero, IL 60804-3739 | 2020-04-15 |
| 1710511399 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 1946 Grand Avenue, Granite City, IL 62040-4613 | 2020-02-24 |
| 1861026478 | Proctor Community Hospital | Clinic/Center | 5401 N Knoxville Ave Ste 104, Peoria, IL 61614-5021 | 2020-02-24 |
| 1033741608 | Fresenius Medical Care New Lenox, LLC | Clinic/Center | 662 Cedar Crossings Dr, New Lenox, IL 60451-5200 | 2020-02-11 |
| 1730725904 | Perryton Dialysis LLC | Clinic/Center | 8604 Woodward Ave, Woodridge, IL 60517-3171 | 2019-11-22 |
| 1124678529 | Dialyze Direct Il LLC | Clinic/Center | 410 S Heinlein Dr, Shelbyville, IL 62565-7800 | 2019-09-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.