Organization
HOPKINTON DIALYSIS LLC
Active
Other names
Ogden 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
6001 W OGDEN AVE, CICERO, IL 60804-3739
(615) 238-3136
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376162735
—
IL
01
—
142872
MEDICARE OSCAR/CERTIFICATION
IL
Enumeration date
04/15/2020
Last updated
11/04/2025
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