Tri-Cities Dialysis LLC
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Geneva, IL. Organization (NPI-2).
NPI number1982607156
StatusActive
Last updated in NPPESJun 19, 2008
Details
- NPI
- 1982607156
- Entity type
- Organization (NPI-2)
- Legal business name
- Tri-Cities Dialysis LLC
- Organization subpart
- No
- Enumeration date
- May 23, 2005
- Last updated
- Jun 19, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | – | – | Yes |
Practice location
306 Randall RdGeneva, IL 60134-4200
Phone 630-262-1306
Mailing address
1300 Waterford DrLowr Level
Aurora, IL 60504-5502
Phone 630-851-1206
Authorized official
Calvin Ganong
Chief Operating Officer
6308511206
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