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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

Other

Enumeration date
08/14/2019
Last updated
02/04/2026
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