# FORT WAYNE VASCULAR CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Nephrology Associates of Northern Indiana PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225684368
- **Authorized official:** MANISH TANNA (MD)
- **Authorized official phone:** (630) 573-5000

## Contact information

- **Practice address:** 1833 MAGNAVOX WAY \# 100, FORT WAYNE, IN 46804-1539
- **Practice address phone:** (260) 918-0997
- **Practice address fax:** (260) 436-7665
- **Mailing address:** 120 W 22ND ST, SUITE 200, OAK BROOK, IL 60523-1563
- **Mailing address phone:** (630) 573-5000
- **Mailing address fax:** (630) 368-0280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RN0300X | Nephrology Physician | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/14/2019
- **Last updated:** 02/04/2026