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Organization
RENALCARE ASSOCIATES, S.C.
Active
Organization
RENALCARE ASSOCIATES, S.C.
Active
Other names
Illinois Kidney Disease and Hypertension Center
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE EYMAN (ADMINISTRATIVE ASSISTANT)
(309) 624-9259
Entity
Organization
Contact information
Practice address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3112
(309) 676-8123
(309) 676-8455
Mailing address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3112
(309) 676-8123
(309) 676-8455
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
042003556
IL
208600000X
Surgery Physician
042003556
IL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7215040
BCBS GROUP NUMBER
IL
05
—
=========
—
IL
01
—
CA301
RAILROAD MEDICARE
IL
Enumeration date
03/06/2007
Last updated
06/24/2026
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