AVERTRAIL DIALYSIS LLC (NPI# 1912482654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912482654 |
| Entity Type | Organization |
| Organization Name | AVERTRAIL DIALYSIS LLC |
| Other Organization Name | SALT CREEK DIALYSIS |
| Practice Address |
196 W. North Avenue Villa Park IL 60181 |
| Mailing Address |
5200 Virginia Way L & C Department Brentwood TN 37027-7569 |
| Practice Telephone | 6302793350 |
| Practice Fax Number | 6302793378 |
| Mailing Telephone | 6153204514 |
| Mailing Fax Number | 8665949961 |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2020-10-20 |
| Authorized Official Name | JOHN WINSTEL (CHEIF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| Is Organization Subpart | N |
| 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 |
|---|---|
| Salt Creek Dialysis | Doing Business As Name - Organization |
| Street Address |
196 W. NORTH AVENUE |
| City | VILLA PARK |
| State | IL |
| Zip Code | 60181 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820812 | Molly Ahitow | Pharmacist | 900 Il-83, Villa Park, IL 60181 | 2020-10-30 |
| 1881200343 | Podiatric Management Systems LLC | Podiatrist | 1 S067 Summit Ave, Oakbrook Terrace, IL 60181 | 2020-09-21 |
| 1093320855 | Rci (wrs), LLC. | Clinic/Center | 17 West 580 Butterfield Road, Oakbrook Terrace, IL 60181 | 2020-09-09 |
| 1720600992 | Mariam Ali | Pharmacist | 900 S. Rt 83, Villa Park, IL 60181 | 2020-05-11 |
| 1255970067 | Lifecare Pharmacy Plus LLC | Pharmacy | 1634 Ardmore Ave, Villa Park, IL 60181 | 2019-12-26 |
| 1497229215 | For Eyes Optical of Pa | Optometrist | 17 W 412-414 22nd St, Ste M&n, Oakbrook Terrace, IL 60181 | 2019-01-15 |
| 1114499928 | Next Step Physiotherapy LLC | Clinic/Center | 1 Parkview Plaza, Oakbrook Terrace, IL 60181 | 2018-12-19 |
| 1922588581 | Neeliyara Inc | Psychologist | 1s045 Spring Road, Unit 1g, Oakbrook Terrace, IL 60181 | 2018-08-14 |
| 1588168439 | Deborah Marie Adolfino | Pedorthist | 1s376 Summit Ave., Ct. E, Oakbrook Terrace, IL 60181 | 2018-03-23 |
| 1902325905 | Vanessa L Owens | Psychologist | 255 S. Harvard Street, Villa Park, IL 60181 | 2017-09-12 |
| Find all providers in zip 60181 | ||||
| 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 |
|---|---|---|---|---|
| 1649675950 | Usrc Vp Home, LLC | Clinic/Center | 202 E North Ave, Villa Park, IL 60181-1221 | 2014-10-29 |
| 1669762050 | Villa Park Home Dialysis LLC | Clinic/Center | 1634 S Ardmore Ave, Villa Park, IL 60181-3742 | 2011-04-19 |
| 1669853206 | Nocturnal Dialysis Spa LLC | Clinic/Center | 1634 S Ardmore Ave, Villa Park, IL 60181-3742 | 2015-06-09 |
| 1093067415 | Usrc Villa Park, LLC | Clinic/Center | 200 E North Ave, Villa Park, IL 60181-1221 | 2012-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550486 | Home Dialysis & Kidney Care Limited | Clinic/Center | 1252 Ogden Ave Ste D, Downers Grove, IL 60515-2740 | 2020-08-28 |
| 1922619824 | Dialysis Care Center Evergreen Park LLC | Clinic/Center | 9834 S Kedzie Ave, Evergreen Park, IL 60805-3135 | 2020-08-13 |
| 1558970525 | Concerto Massachusetts LLC | Clinic/Center | 4600 W Touhy Ave Ste 100, Lincolnwood, IL 60712-1606 | 2020-07-27 |
| 1629697917 | East Oaks Dialysis LLC | Clinic/Center | 2950 W 26th St, Chicago, IL 60623 | 2020-04-16 |
| 1376162735 | Hopkinton Dialysis LLC | Clinic/Center | 6001 W Ogden Ave, Cicero, IL 60804-3739 | 2020-04-15 |
| 1710511399 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 1946 Grand Avenue, Granite City, IL 62040-4613 | 2020-02-24 |
| 1861026478 | Proctor Community Hospital | Clinic/Center | 5401 N Knoxville Ave Ste 104, Peoria, IL 61614-5021 | 2020-02-24 |
| 1033741608 | Fresenius Medical Care New Lenox, LLC | Clinic/Center | 662 Cedar Crossings Dr, New Lenox, IL 60451-5200 | 2020-02-11 |
| 1730725904 | Perryton Dialysis LLC | Clinic/Center | 8604 Woodward Ave, Woodridge, IL 60517-3171 | 2019-11-22 |
| 1124678529 | Dialyze Direct Il LLC | Clinic/Center | 410 S Heinlein Dr, Shelbyville, IL 62565-7800 | 2019-09-17 |
| Find all providers with the same taxonomy | ||||
| City | VILLA PARK |
| Zip Code | 60181 |
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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.