Organization
ISD RENAL INC
Active
Other names
Waukegan Renal Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3350 GRAND AVE STE 100, WAUKEGAN, IL 60085-2206
(847) 782-0640
(847) 599-9563
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
07/14/2006
Last updated
07/09/2024
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