Organization
RENALCARE ASSOCIATES, S.C.
Active
Other names
Illinois Kidney Disease and Hypertension Center
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE EYMAN (ADMINISTRATIVE ASSISTANT)
(309) 624-9259
Entity
Organization
Contact information
Practice address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3112
(309) 676-8123
(309) 676-8455
Mailing address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3112
(309) 676-8123
(309) 676-8455
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
042003556
IL
208600000X
Surgery Physician
042003556
IL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7215040
BCBS GROUP NUMBER
IL
05
—
=========
—
IL
01
—
CA301
RAILROAD MEDICARE
IL
Enumeration date
03/06/2007
Last updated
02/12/2026
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