Organization
DIALYSIS OF NORTHERN ILLINOIS LLC
Active
Other names
Monroe Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS O USILTON JR. (SR VICE PRESIDENT)
(770) 541-7922
Entity
Organization
Contact information
Practice address
114 8TH ST, MONROE, WI 53566-1050
(608) 325-3585
(608) 325-3981
Mailing address
5200 VIRGINIA WAY, 4TH FLOOR L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4521
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
—
1598774929
—
WI
Enumeration date
08/05/2006
Last updated
10/19/2009
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