Organization
IROQUOIS KIDNEY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL HIZON MD (MANAGER)
(815) 937-4422
Entity
Organization
Contact information
Practice address
209 S 5TH ST, WATSEKA, IL 60970-1659
(815) 937-4422
Mailing address
455 W COURT ST, SUITE 304, KANKAKEE, IL 60901-3679
(815) 937-4422
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
APPLIED FOR
IL
Other
Enumeration date
11/10/2011
Last updated
11/10/2011
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