Organization Name: | QUALITY RENAL CARE LLC |
NPI Number: | 1740233154 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BETH ANN GIRARD (RENAL ADMINISTRATOR) |
Mailing Address: | 2203 Randall Road Carpentersville |
State: | IL US |
Postal Code: | 60110 |
Phone Number: | 8474266456 |
Fax Number: | 8474264795 |
NPI Enumeration Date: | 05/18/2006 |
NPI Last Update Date: | 12/19/2008 |
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: |