Organization Name: | FRESENIUS MEDICAL CARE OAK FOREST, LLC |
NPI Number: | 1255763181 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK R FAWCETT (TREASURER) |
Mailing Address: | 5340a W 159th Street Oak Forest |
State: | IL US |
Postal Code: | 604523326 |
Phone Number: | 7085350080 |
Fax Number: | 7085350133 |
NPI Enumeration Date: | 08/02/2013 |
NPI Last Update Date: | 03/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |