Organization · Type 2 NPI

Isd Renal Inc

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

NPI number 1659397859 Active

Practice location

3350 Grand Ave Ste 100
Waukegan, IL 60085-2206

Call (847) 782-0640 Map

Fax (847) 599-9563

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...

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NPI record

NPI: 1659397859
Entity type: Organization (Type 2)
Issued: Jul 14, 2006
Last updated: Jul 9, 2024
Status: Active

Other names

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Waukegan Renal Center · doing business as
Waukegan Renal Center · doing business as

Authorized official

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

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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 1659397859

Isd Renal Inc's National Provider Identifier is 1659397859, issued on Jul 14, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Waukegan, IL. The record was last updated on Jul 9, 2024.