Organization
RENAL TREATMENT CENTERS-ILLINOIS INC
Active
Other names
Dixon Kidney Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1131 N GALENA AVE, DIXON, IL 61021-1015
(815) 284-0595
(815) 284-0547
Mailing address
5200 VIRGINIA WAY, LICENSURE AND CERTIFICATION, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
N/A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184868267
—
IL
Enumeration date
03/28/2006
Last updated
10/18/2023
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