Organization
EBREA DIALYSIS LLC
Active
Other names
Flossmoor Home Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
19720 GOVERNORS HWY STE 2, FLOSSMOOR, IL 60422-2029
(708) 799-7239
(708) 799-1252
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
07/23/2013
Last updated
03/17/2025
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