Organization Name: | FRESENIUS MEDICAL CARE OF ILLINOIS, LLC |
NPI Number: | 1164512661 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK FAWCETT (TREASURER) |
Mailing Address: | 101 Waukegan Rd Suite 700 Lake Bluff |
State: | IL US |
Postal Code: | 600441687 |
Phone Number: | 8477350870 |
Fax Number: | |
NPI Enumeration Date: | 10/13/2006 |
NPI Last Update Date: | 11/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |