AXOLOTL, LLC (NPI# 1609136019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609136019 |
| Entity Type | Organization |
| Organization Name | AXOLOTL, LLC |
| Practice Address |
130 E Clark St Harrisburg IL 62946-2700 |
| Mailing Address |
1507 Gleneagle Dr Marion IL 62959-5231 |
| Practice Telephone | 6189229952 |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2012-05-18 |
| Authorized Official Name | KEVIN CHEN (OWNER) |
| Authorized Official Telephone | 6189229952 |
| 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 |
| Street Address |
130 E CLARK ST |
| City | HARRISBURG |
| State | IL |
| Zip Code | 62946-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326196783 | Roger K. Lyons | Counselor | 130 E Clark St, Specialists Clinic, Harrisburg, IL 62946-2700 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770195117 | Leslie Wheeler | Pharmacist | #4 Commercial Drive, Harrisburg, IL 62946 | 2020-08-18 |
| 1215337266 | Prn Pharmacies Ltd | Durable Medical Equipment & Medical Supplies | 501 E. Sloan St., Harrisburg, IL 62946 | 2014-08-27 |
| 1316293855 | Steward Chiropractic Center, LLC | Chiropractor | 608 Rollie Moore Dr., Suite 2, Harrisburg, IL 62946 | 2012-08-02 |
| 1558664664 | Harrisburg Medical Center Inc | Clinic/Center | 183 W Lane St, Equality, IL 62946 | 2010-12-10 |
| 1588849178 | Scarlett Annette Oyler | Technician, Other | 607 W Commercial Suite, Harrisburg, IL 62946 | 2008-01-02 |
| 1043427958 | Debbie Oglesby | Case Manager/Care Coordinator | #22 Veterans Drive, Harrisburg, IL 62946 | 2007-05-17 |
| 1336272764 | Coleman Tri-county Services, Inc. | Community/Behavioral Health | # 22 Veterans Drive, Harrisburg, IL 62946 | 2007-03-14 |
| 1437212081 | Harris Frank LLC | Skilled Nursing Facility | Harrisburg Care Center, 1000 West Sloan St, Harrisburg, IL 62946 | 2006-12-18 |
| 1932269701 | Leanne H Deneal | Physician Assistant | 28 Veteran's Drive, Harrisburg, IL 62946 | 2006-12-11 |
| 1881646990 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 20 Veterans Drive, Harrisburg, IL 62946 | 2006-05-17 |
| Find all providers in zip 62946 | ||||
| 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 |
|---|---|---|---|---|
| 1417599168 | Renal Treatment Centers - Mid-atlantic Inc | Clinic/Center | 8000c Derry St, Harrisburg, PA 17111-5200 | 2019-10-15 |
| 1356897938 | Millonee Dialysis LLC | Clinic/Center | 4390 Sturbridge Dr, Harrisburg, PA 17110 | 2016-09-01 |
| 1740690064 | Fenton Dialysis LLC | Clinic/Center | 303 S Commercial St Ste 15, Harrisburg, IL 62946-2125 | 2014-05-08 |
| 1629330469 | Cedar Dialysis LLC | Clinic/Center | 479 Port View Dr, Ste B21, Harrisburg, PA 17111-1229 | 2012-06-07 |
| 1063516839 | Bio-medical Applications of Pennsylvania, Inc. | Clinic/Center | 1300 Linglestown Rd, Harrisburg, PA 17110-2838 | 2006-09-12 |
| 1952405821 | Bio-medical Applications of Pennsylvania, Inc. | Clinic/Center | 4343 Union Deposit Rd, Union Court, Harrisburg, PA 17111-2907 | 2006-09-12 |
| 1801901640 | Bio-medical Applications of Illinois, Inc. | Clinic/Center | 275 Small St, Harrisburg, IL 62946-3352 | 2006-08-20 |
| 1174131783 | Serenity Blue LLC | Clinic/Center | 2232 Chatham Way, Harrisburg, PA 17110-3959 | 2020-07-20 |
| 1841394624 | Renal Care Group East, Inc. | Clinic/Center | 2601 N 3rd St, Harrisburg, PA 17110-2046 | 2006-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 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 | ||||
| City | HARRISBURG |
| Zip Code | 62946 |
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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.