Organization · Type 2 NPI

Dva Renal Healthcare Inc

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

NPI number 1205805488 Active

Practice location

112 Sullivan Dr
Rushville, IL 62681-1293

Call (217) 322-2652 Map

Fax (217) 322-4893

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: 1205805488
Entity type: Organization (Type 2)
Issued: Mar 17, 2006
Last updated: Feb 11, 2026
Status: Active

Other names

<unavail>
Rushville Dialysis · doing business as
Rushville Dialysis · doing business as

Authorized official

Samuel T Wey
VP, Licensure & Certification
(615) 341-6641

Verify this record

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 1205805488

Dva Renal Healthcare Inc's National Provider Identifier is 1205805488, issued on Mar 17, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Rushville, IL. The record was last updated on Feb 11, 2026.