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Organization
FORT WAYNE VASCULAR CARE LLC
Active
Organization
FORT WAYNE VASCULAR CARE LLC
Active
Other names
Nephrology Associates of Northern Indiana PC
Organization subpart
No
Provider details
NPI number
Authorized official
MANISH TANNA (MD)
(630) 573-5000
Entity
Organization
Contact information
Practice address
1833 MAGNAVOX WAY # 100, FORT WAYNE, IN 46804-1539
(260) 918-0997
(260) 436-7665
Mailing address
120 W 22ND ST, SUITE 200, OAK BROOK, IL 60523-1563
(630) 573-5000
(630) 368-0280
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/14/2019
Last updated
02/04/2026
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