KIDNEY CARE CENTER OLYMPIA FIELDS LLC (NPI# 1619389715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619389715 |
| Entity Type | Organization |
| Organization Name | KIDNEY CARE CENTER OLYMPIA FIELDS LLC |
| Practice Address |
3302 Vollmer Rd Olympia Fields IL 60461-1179 |
| Mailing Address |
Po Box 3877 Joliet IL 60434-3877 |
| Practice Telephone | 7088980811 |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2020-05-12 |
| Authorized Official Name | DR. MORUFU ALAUSA (MEDICAL DIRECTOR/CEO) |
| Authorized Official Telephone | 8157416830 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3322 Vollmer Rd, Olympia Fields, IL 604611179 | 7088980811 | 7088981839 |
| Street Address |
3302 VOLLMER RD |
| City | OLYMPIA FIELDS |
| State | IL |
| Zip Code | 60461-1179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417321241 | Angel Watkins | Nurse Practitioner | 3302 Vollmer Rd, Olympia Fields, IL 60461-1179 | 2015-11-17 |
| 1093190076 | Mustafa Hunaid Kagalwalla | Internal Medicine | 3302 Vollmer Rd, Olympia Fields, IL 60461-1179 | 2015-07-20 |
| 1659750743 | Chidinma Nnenna Ekenna | Internal Medicine | 3302 Vollmer Rd, Olympia Fields, IL 60461-1179 | 2015-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609372564 | Katherine Gill Haddad | Student in an Organized Health Care Education/Training Program | 20201 S. Crawford Avenue, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2018-03-31 |
| 1750886610 | Kim Minh Dang | Student in an Organized Health Care Education/Training Program | 20201 South Crawford, Olympia Fields, IL 60461 | 2018-03-23 |
| 1619484110 | Alexandra N. Douvas | Dentist | 20180 Governors Hwy, Ste 104, Olympia Fields, IL 60461 | 2018-01-05 |
| 1992258438 | Krystyne Doty | Nurse Practitioner | 3800 W 203rd St Ste 209, Olympia Fields, IL 60461 | 2016-08-02 |
| 1205286747 | Shirlene Umali | Registered Nurse | 20201 South Crawford Ave, Olympia Fields, IL 60461 | 2016-06-15 |
| 1386002590 | Touch of Wholeness Psychological Services, LLC | Psychologist | 20280 Governors Dr, Suite 207, Olympia Fields, IL 60461 | 2016-02-02 |
| 1063895357 | David Dardick | Dentist | 20180 Governors Hwy Ste 104, Olympia Fields, IL 60461 | 2015-07-04 |
| 1811378623 | Fins Healthcare Agency | Nursing Care | 3612 Lincohn Highway, Suite 19, Olympia Fields, IL 60461 | 2015-06-17 |
| 1285048959 | Garud Ranga Raj | Orthopaedic Surgery | 20817 Alexander St, Olympia Fields, IL 60461 | 2014-06-20 |
| 1811316334 | Brett Hapeman | Emergency Medicine | 20201 S Crawford, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2014-04-11 |
| Find all providers in zip 60461 | ||||
| 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 |
|---|---|---|---|---|
| 1013208412 | Albara Said | Internal Medicine | 3322 Vollmer Rd, Suite B, Olympia Fields, IL 60461-1179 | 2011-04-20 |
| 1265685242 | Suresh Nelson Samson | Internal Medicine | 3322 Vollmer Rd Ste B, Olympia Fields, IL 60461-1179 | 2008-11-04 |
| 1093190076 | Mustafa Hunaid Kagalwalla | Internal Medicine | 3302 Vollmer Rd, Olympia Fields, IL 60461-1179 | 2015-07-20 |
| 1659750743 | Chidinma Nnenna Ekenna | Internal Medicine | 3302 Vollmer Rd, Olympia Fields, IL 60461-1179 | 2015-05-22 |
| 1164787792 | Syed Affan Ul Haq Hashmi | Internal Medicine | 3322 Vollmer Rd, Suite B, Olympia Fields, IL 60461-1179 | 2012-07-10 |
| 1235442443 | Tauseef Sarguroh | Internal Medicine | 3322 Vollmer Rd Ste B, Olympia Fields, IL 60461-1179 | 2010-07-16 |
| 1083809081 | Nicholas Mahesh Shah | Internal Medicine | 20201 Crawford Ave, Olympia Fields, IL 60461-1010 | 2007-09-12 |
| 1215052121 | Ali Raza Khan | Internal Medicine | 20121 Crawford Ave, Olympia Fields, IL 60461-1009 | 2007-03-20 |
| 1730274770 | Don Leroy Hollandsworth | Internal Medicine | 4001 Vollmer Rd., Olympia Fields, IL 60461-1073 | 2006-10-04 |
| 1508952011 | Edwin John Cook | Internal Medicine | 4001 Vollmer Rd., Olympia Fields, IL 60461 | 2006-10-04 |
| Find all providers in OLYMPIA FIELDS | ||||
| City | OLYMPIA FIELDS |
| Zip Code | 60461 |
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| 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.