Organization
GREAT LAKES DIALYSIS WEST LLC
Active
Other names
Dialysis Care Center Great Lakes West
Organization subpart
No
Provider details
NPI number
Authorized official
MORUFU OLATUNJI ALAUSA MD (AUTHORIZED OFFICIAL / CMO)
(815) 741-6830
Entity
Organization
Contact information
Practice address
27150 W 8 MILE RD, SOUTHFIELD, MI 48033-3590
(248) 914-0121
Mailing address
PO BOX 428, LOCKPORT, IL 60441-6428
(815) 714-7170
(630) 672-4980
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
12/15/2013
Last updated
04/07/2025
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