Organization
RENAL TREATMENT CENTERS-ILLINOIS INC
Active
Other names
Southfield West Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
21900 MELROSE AVE STE 4, SOUTHFIELD, MI 48075-7967
(248) 356-8079
(248) 356-8151
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, 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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508828708
—
MI
Enumeration date
05/06/2015
Last updated
08/23/2022
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