Organization · Type 2 NPI

Dva Renal Healthcare Inc

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

NPI number 1275502437 Active

Practice location

1004 W Anthony Dr
Champaign, IL 61821-1205

Call (217) 355-7020 Map

Fax (217) 355-7313

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: 1275502437
Entity type: Organization (Type 2)
Issued: Mar 17, 2006
Last updated: Mar 13, 2025
Status: Active

Other names

<unavail>
Illini Renal Dialysis · doing business as
Illini Renal Dialysis · doing business as

Authorized official

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

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About NPI 1275502437

Dva Renal Healthcare Inc's National Provider Identifier is 1275502437, 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 Champaign, IL. The record was last updated on Mar 13, 2025.