FRESENIUS MEDICAL CARE OF ILLINOIS, LLC (NPI# 1639628415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639628415 |
| Entity Type | Organization |
| Organization Name | FRESENIUS MEDICAL CARE OF ILLINOIS, LLC |
| Other Organization Name | FRESENIUS KIDNEY CARE HUMBOLDT PARK |
| Practice Address |
3520 West Grand Chicago IL 60651 |
| Practice Telephone | 7732766802 |
| Practice Fax Number | 7732766844 |
| Mailing Telephone | 7732766802 |
| Mailing Fax Number | 7732766844 |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |
| Authorized Official Name | MARK R FAWCETT (SR. VP AND TREASURER) |
| Authorized Official Telephone | 7816999000 |
| Is Organization Subpart | Y |
| Parent Organization Name | FRESENIUS MEDICAL CARE HOLDINGS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Fresenius Kidney Care Humboldt Park | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710511399 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 1946 Grand Avenue, Granite City, IL 62040-4613 | 2020-02-24 |
| 1467971333 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 6525 W Main St, Belleville, IL 62223-3703 | 2017-09-12 |
| 1861882227 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 624 Voris-jost Dr., Waterloo, IL 62298-1568 | 2015-01-23 |
| 1578964565 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 1657 Old Skokie Valley Rd, Highland Park, IL 60035-2349 | 2014-09-09 |
| 1760761316 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 1402 Townline Rd, Mundelein, IL 60060-4433 | 2011-08-15 |
| 1912292533 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 110 N West St, Waukegan, IL 60085-4330 | 2011-06-10 |
| 1043510217 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 219 E 34th St, Steger, IL 60475-1201 | 2010-10-22 |
| 1992032767 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 6201 W 63rd St, Chicago, IL 60638-5009 | 2009-11-15 |
| 1316188956 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 405 Lake Cook Rd Ste A13, Deerfield, IL 60015-5284 | 2009-03-11 |
| 1093955635 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 1960 Springer Dr, Lombard, IL 60148-6419 | 2009-02-23 |
| Street Address |
3520 WEST GRAND |
| City | CHICAGO |
| State | IL |
| Zip Code | 60651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215474978 | Kanesha Walker Amaro | Counselor | 5910 W Division, Chicago, IL 60651 | 2017-01-19 |
| 1326596321 | Giselle Tisha Wallace | Nurse's Aide | 5809 W Rice, Chgo, IL 60651 | 2016-09-19 |
| 1811385214 | Jeanette Rodriguez | Social Worker | 1116 N Kedzie Av. Office#257, Association House of Chicago, Chicago, IL 60651 | 2015-01-07 |
| 1801147475 | Diane Dickens-rogers | Massage Therapist | 5700 W. Chicago Ave., Chicago, IL 60651 | 2012-09-24 |
| 1891045241 | Association House of Chicago | Residential Treatment Facility, Emotionally Disturbed Children | 1900 North Sawyer Avenue, Chicago, IL 60651 | 2012-09-13 |
| 1770860983 | Christine C Osborne | Pharmacist | 1541 N.central Ave, Chicago, IL 60651 | 2011-11-16 |
| 1629206388 | Habilitative Systems Inc | Case Management | 1049 N Drake Ave, Chicago, IL 60651 | 2009-07-01 |
| 1841428547 | Habilitative Systems, Inc. | Case Management | 4234 W Potomac Ave, Chicago, IL 60651 | 2009-07-01 |
| 1306074000 | Habilitative Systems, Inc | Case Management | 915 N Massasoit Ave, Chicago, IL 60651 | 2009-07-01 |
| 1740438613 | Association House of Chicago | Clinic/Center | 1116 N. Kedzie, Chicago, IL 60651 | 2008-09-04 |
| Find all providers in zip 60651 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629697917 | East Oaks Dialysis LLC | Clinic/Center | 2950 W 26th St, Chicago, IL 60623 | 2020-04-16 |
| 1871146761 | Fresenius Medical Care West Metro, LLC | Clinic/Center | 1044 N Mozart St Ste 3, Chicago, IL 60622-4477 | 2019-07-19 |
| 1487139085 | Dunklinson Dialysis LLC | Clinic/Center | 2640 N Narragansett Ave Ste D8, Chicago, IL 60639-1096 | 2018-09-28 |
| 1154801702 | Total Renal Care Inc | Clinic/Center | 8159 S Cicero Ave, Chicago, IL 60652-2017 | 2018-08-14 |
| 1497258693 | Dialysis Care Center Beverly LLC | Clinic/Center | 10801 S Western Ave Ste 100, Chicago, IL 60643-3297 | 2018-03-14 |
| 1699288092 | Itasca Dialysis LLC | Clinic/Center | 4737 S California Ave, Chicago, IL 60632-2015 | 2017-11-08 |
| 1821507674 | Total Renal Care Inc | Clinic/Center | 4323 N Pulaski Rd, Chicago, IL 60641-2155 | 2017-09-25 |
| 1851813216 | Usrc West Chicago, LLC | Clinic/Center | 112 W 87th St Ste N, Chicago, IL 60620-1318 | 2017-07-07 |
| 1649790510 | Fresenius Medical Care Chicagoland, LLC | Clinic/Center | 9924 S Vincennes Avenue, Chicago, IL 60643-1303 | 2017-06-22 |
| 1548791163 | Pawlier Dialysis LLC | Clinic/Center | 9505 S Colfax Ave, Chicago, IL 60617-4976 | 2017-03-24 |
| Find all providers in CHICAGO | ||||
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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.