Organization
CHANNAHON HOME DIALYSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA LEE JANSSEN (ADMINSITRATOR)
(815) 744-5550
Entity
Organization
Contact information
Practice address
27025 W EAMES ST, CHANNAHON, IL 60410-5619
(815) 744-5550
Mailing address
3100 THEODORE ST, JOLIET, IL 60435-8534
(815) 744-5550
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/30/2018
Last updated
06/03/2019
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