Organization · Type 2 NPI
Itasca Dialysis LLC
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Chicago, IL
NPI number
1699288092
Active
Practice location
4737 S California Ave
Chicago, IL 60632-2015
Fax (773) 523-2468
Mailing address
5200 Virginia Way, Att: 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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About NPI 1699288092
Itasca Dialysis LLC's National Provider Identifier is 1699288092, issued on Nov 8, 2017. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Chicago, IL. The record was last updated on Jul 15, 2024.