Organization
RENAL TREATMENT CENTERS-ILLINOIS, INC
Active
Other names
Manteno Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSING & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1 E DIVISION ST, MANTENO, IL 60950-1507
(815) 468-1000
(815) 468-7271
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
11/06/2023
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