Organization
HOME DIALYSIS & KIDNEY CARE LIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD VASEEMUDDIN MD (PRESIDENT)
(847) 323-5491
Entity
Organization
Contact information
Practice address
1252 OGDEN AVE STE D, DOWNERS GROVE, IL 60515-2740
(630) 876-9000
(630) 559-9004
Mailing address
1252 OGDEN AVE STE D, DOWNERS GROVE, IL 60515-2740
(630) 876-9000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
—
—
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-110447
—
IL
Enumeration date
08/28/2020
Last updated
03/26/2024
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