Organization
DIALYSIS OF NORTHERN ILLINOIS LLC
Active
Other names
Timber Creek Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1001 S ANNIE GLIDDEN RD, DEKALB, IL 60115-8250
(815) 748-3074
(815) 748-3148
Mailing address
5200 VIRGINIA WAY, LICENSURE AND CERTIFICATION, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/28/2013
Last updated
01/20/2025
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