Organization
MEDICAL DISTRICT HOME DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES WEIS (CFO)
(773) 257-6642
Entity
Organization
Contact information
Practice address
1501 S CALIFORNIA AVE, SUITE 119, CHICAGO, IL 60608-1732
(773) 257-6642
Mailing address
1501 S CALIFORNIA AVE, SUITE 119, CHICAGO, IL 60608-1732
(773) 257-6642
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
02/09/2015
Last updated
02/09/2015
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