Organization · Type 2 NPI

Renal Treatment Centers-Illinois Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Bourbonnais, IL

NPI number 1073675138 Active

Practice location

581 William R Latham Sr Dr Ste 104
Bourbonnais, IL 60914-2439

Call (815) 936-3088 Map

Fax (815) 936-3756

Mailing address

5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

NPI record

NPI: 1073675138
Entity type: Organization (Type 2)
Issued: Dec 15, 2006
Last updated: Mar 7, 2023
Status: Active

Other names

<unavail>
Kankakee County Dialysis · doing business as
Kankakee County Dialysis · doing business as

Authorized official

John Winstel
Chief Accounting Officer
(253) 733-4501

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1073675138

Renal Treatment Centers-Illinois Inc's National Provider Identifier is 1073675138, issued on Dec 15, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Bourbonnais, IL. The record was last updated on Mar 7, 2023.