Organization
PRS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK PICK (OWNER)
(847) 372-4243
Entity
Organization
Contact information
Practice address
188 W INDUSTRIAL DR, SUITE 100, ELMHURST, IL 60126-1623
(630) 359-3238
Mailing address
188 W INDUSTRIAL DR, SUITE 100, ELMHURST, IL 60126-1623
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
01
—
50655
BLUE CROSS BLUE SHIELD OF ILLINOIS
—
Enumeration date
06/18/2006
Last updated
08/02/2011
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