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Organization

WESTERN ILLINOIS KIDNEY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PARTHA SRINIVASAN M.D (CEO & MEDICAL DIRECTOR)
(309) 345-4580
Entity
Organization

Contact information

Practice address
765 N KELLOGG ST, SUITE 101, GALESBURG, IL 61401-2875
(309) 345-4580
(309) 345-4581
Mailing address
765 N KELLOGG ST, SUITE 101, GALESBURG, IL 61401-2875
(309) 345-4580
(309) 345-4581

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
001
IL

Other

Enumeration date
01/17/2006
Last updated
07/21/2022
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