NEPHROLOGY ASSOCIATES OF NORTHERN ILLINOIS (NPI# 1447403852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447403852 |
| Entity Type | Organization |
| Organization Name | NEPHROLOGY ASSOCIATES OF NORTHERN ILLINOIS |
| Practice Address |
650 Dakota St Suite C Crystal Lake IL 60012-3744 |
| Mailing Address |
855 Madison St Nephrology Associates of Northern Illinois Oak Park IL 60302-4420 |
| Practice Telephone | 8153011001 |
| Practice Fax Number | 8153011002 |
| Mailing Telephone | 7083861000 |
| Mailing Fax Number | 7083862839 |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2010-08-23 |
| Authorized Official Name | MR. BRIAN O'DEA (CFO/COO) |
| Authorized Official Telephone | 7083861000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
036110997 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | PROVIDER NPI NUMBER | 1548210677 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134319924 | Nephrology Associates of Northern Illinois | Internal Medicine | On25winfield Road, Winfield, IL 60190 | 2007-07-27 |
| 1063605053 | Nephrology Associates of Northern Illinois | Internal Medicine | 114 8th St, Monroe, WI 53566-1050 | 2007-08-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | NEPHROLOGY ASSOCIATES OF NORTHERN ILLINOIS LTD | 120 W. 22nd Street, Oak Brook, IL 60523 |
| Street Address |
650 DAKOTA ST SUITE C |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60012-3744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760476311 | Fox Valley Internal Medicine, LLC | Physical Therapist | 650 Dakota St, Suite A, Crystal Lake, IL 60012-3744 | 2005-09-09 |
| 1922374024 | Jonathan Huang | Internal Medicine | 650 Dakota St, Suite A, Crystal Lake, IL 60012-3744 | 2012-03-23 |
| 1215263066 | Ambassador Hospital Care, LLC | Hospitalist | 650 Dakota St, Suite A, Crystal Lake, IL 60012-3744 | 2009-10-29 |
| 1730203266 | Sowjanya Pinnamaneni | Physical Therapist | 650 Dakota St, Suite A, Crystal Lake, IL 60012-3744 | 2007-03-19 |
| 1265543557 | Kathi Lyne Bliler | Physician Assistant | 650 Dakota St, Suite A, Crystal Lake, IL 60012-3744 | 2006-08-31 |
| 1851405716 | Fox Valley Podiatrists of Mchenry County | Podiatrist | 650 Dakota St, Suite B, Crystal Lake, IL 60012-3744 | 2006-08-18 |
| 1922053149 | Amanda K. Hollensbe | Physical Therapist | 650 Dakota St, Crystal Lake, IL 60012-3744 | 2006-05-24 |
| 1861443236 | Carol Sue Letner | Physical Therapist | 650 Dakota St, Suite A, Crystal Lake, IL 60012-3744 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033574629 | Joan M Ryan | Counselor | 610 N Route 31, Suite E, Crystal Lake, IL 60012 | 2015-12-23 |
| 1285972331 | Lauren Elyse Westerman | Physical Therapist | 1000 Brighton Ln, Crystal Lake, IL 60012 | 2013-01-24 |
| 1447537469 | Sean Gale | Pharmacist | 135 Carmella Dr, Crystal Lake, IL 60012 | 2011-11-04 |
| 1477836625 | Judy Meekyung Fakhouri | Pharmacist | 315 N. Route 31, Crystal Lake, IL 60012 | 2011-09-23 |
| 1730462136 | Leslie Dawn Weckerlin | Pharmacist | 315 N Route 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1639452188 | Laura Jean Galles | Pharmacist | 315 N. Routet 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1326320516 | Stacey Jean Knuth | Pharmacist | 315 North Route 31, Crystal Lake, IL 60012 | 2011-09-13 |
| 1356469803 | Donn Orien Humphries | Chiropractor | 690 N Route 31, Suite F, Crystal Lake, IL 60012 | 2007-03-26 |
| 1538204508 | Midwest Physical Therapy Ctr | Clinic/Center | 630 N Rt 31, Suite 103, Crystal Lake, IL 60012 | 2007-02-20 |
| 1356488415 | Charlotte Joy Parcels | Social Worker | 8600 Route 14, Suite 110, Crystal Lake, IL 60012 | 2007-01-30 |
| Find all providers in zip 60012 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033163449 | Irfan K Moinuddin | Internal Medicine | 442 N Il Route 31, Crystal Lake, IL 60012-3709 | 2006-05-20 |
| 1881959872 | Tisha Joerla Mirasol Tan | Internal Medicine | 442 N Il Route 31, Crystal Lake, IL 60012-3709 | 2012-07-06 |
| 1508126764 | Kidney Care Center Elgin LLC | Internal Medicine | 442 N Il Route 31, Crystal Lake, IL 60012-3709 | 2012-05-22 |
| 1508145327 | Venkata L.n.v.k Buddharaju | Internal Medicine | 442 N Il Route 31, Apartment, Crystal Lake, IL 60012-3709 | 2011-08-10 |
| 1750549473 | Farhan J Bangash | Internal Medicine | 442 N Il Route 31, Crystal Lake, IL 60012-3709 | 2008-05-29 |
| 1487831202 | Sumit Bector | Internal Medicine | 390 E Congress Pkwy Ste C, Crystal Lake, IL 60014-6202 | 2008-01-23 |
| 1831378330 | Amit Arora | Internal Medicine | 390 E Congress Pkwy Ste C, Nephrology Associates of Northern Illinois, Crystal Lake, IL 60014-6202 | 2007-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154987618 | Kireet Agrawal Incorporated | Internal Medicine | 17680 Kedzie Ave Ste 201, Hazel Crest, IL 60429-2088 | 2019-05-10 |
| 1235627332 | Chicago Nephrology Associates, LLC | Internal Medicine | 3023 N Clark St #302, Chicago, IL 60657 | 2018-04-25 |
| 1619328820 | Nay Seif | Internal Medicine | 675 N Saint Clair St Ste 250, Chicago, IL 60611-5975 | 2016-06-29 |
| 1447611389 | Skyline Medical Associates LLC | Internal Medicine | 100 E 14th St Apt 1907, Chicago, IL 60605-3673 | 2016-03-18 |
| 1013301605 | Anand Ramadorai | Internal Medicine | 1550 N Northwest Hwy Ste 303, Park Ridge, IL 60068-1460 | 2015-03-23 |
| 1578955654 | R. Gandhi Md S C | Internal Medicine | 602 N East Ave, Oak Park, IL 60302-1716 | 2015-02-25 |
| 1619389715 | Kidney Care Center Olympia Fields LLC | Internal Medicine | 3302 Vollmer Rd, Olympia Fields, IL 60461-1179 | 2014-05-22 |
| 1548687783 | Salim Mujais | Internal Medicine | 2742 The Mews, Northbrook, IL 60062-2617 | 2014-03-26 |
| 1972936581 | Marshall David Lindheimer | Internal Medicine | 5807 S Dorchester Ave, 5e, Chicago, IL 60637-1729 | 2013-08-19 |
| 1649616822 | Bun Siu L. Co | Internal Medicine | 838 Highland Rd., Frankfort, IL 60423 | 2013-05-15 |
| Find all providers with the same taxonomy | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60012 |
Please comment or provide details below to improve the information on NEPHROLOGY ASSOCIATES OF NORTHERN ILLINOIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.