Organization
DIALYSIS OF NORTHERN ILLINOIS LLC
Active
Other names
Belvidere 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
1751 HENRY LUCKOW LN, BELVIDERE, IL 61008-1702
(815) 544-0311
(815) 544-9292
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
—
=========
—
IL
Enumeration date
12/09/2014
Last updated
01/13/2026
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