DIALYSIS CARE CENTER EVERGREEN PARK LLC (NPI# 1922619824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922619824 |
| Entity Type | Organization |
| Organization Name | DIALYSIS CARE CENTER EVERGREEN PARK LLC |
| Practice Address |
9834 S Kedzie Ave Evergreen Park IL 60805-3135 |
| Mailing Address |
Po Box 3134 Joliet IL 60434-3134 |
| Practice Telephone | 7089183200 |
| Practice Fax Number | 7089183201 |
| Mailing Telephone | 8157416830 |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | MORUFU OLATUNJI ALAUSA (CHIEF MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8157416830 |
| 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 |
9834 S KEDZIE AVE |
| City | EVERGREEN PARK |
| State | IL |
| Zip Code | 60805-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| 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 |
|---|---|---|---|---|
| 1467992651 | Fresenius Medical Care Chicagoland, LLC | Clinic/Center | 8901 S Kedzie Ave, Evergreen Park, IL 60805-1222 | 2017-03-07 |
| 1265540181 | National Medical Care, Inc. | Clinic/Center | 9730 S Western Avenue, Evergreen Park, IL 60805-2814 | 2006-08-29 |
| 1669805933 | Fresenius Medical Care Chicagoland, LLC | Clinic/Center | 9730 S Western Ave, Evergreen Park, IL 60805-2814 | 2013-08-09 |
| 1457529943 | Fresenius Medical Care Comprehensive Ckd Services Inc | Clinic/Center | 9730 S Western Ave, Ckd Services of Evergreen Park, Evergreen Park, IL 60805-2814 | 2008-02-19 |
| 1952356453 | National Medical Care Inc. | Clinic/Center | 9730 S Western Ave, Evergreen Park, IL 60805-2814 | 2006-05-23 |
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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 |
| 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 |
| 1609425651 | Joliet Dialysis LLC | Clinic/Center | 214 Collins St, Joliet, IL 60432-2919 | 2019-09-11 |
| Find all providers with the same taxonomy | ||||
| City | EVERGREEN PARK |
| Zip Code | 60805 |
Please comment or provide details below to improve the information on DIALYSIS CARE CENTER EVERGREEN PARK LLC.
| 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.