Organization
LINCOLN PARK DIALYSIS SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2484 N ELSTON AVE, CHICAGO, IL 60647-2002
(773) 278-4403
(773) 489-6986
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/20/2006
Last updated
01/15/2025
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