Organization
RENAL TREATMENT CENTERS-ILLINOIS INC
Active
Other names
Granite City Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
9 AMERICAN VLG, GRANITE CITY, IL 62040-3706
(618) 452-5858
(618) 452-6868
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
03/21/2006
Last updated
01/14/2025
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