Organization
DIALYSIS OF NORTHERN ILLINOIS LLC
Active
Other names
Owen Center Home Training
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3927 W RIVERSIDE BLVD, ROCKFORD, IL 61101-9507
(815) 963-8010
(815) 963-7921
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
02/08/2018
Last updated
06/18/2025
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