OPTIMUM KIDNEY CARE SC NPI 1306893797

NPI Information

NPI: 1306893797
Provider Name: OPTIMUM KIDNEY CARE SC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
331 W SURF ST STE 703
CHICAGO, IL
ZIP 60657
Phone: (773) 525-4701
Get Directions

OPTIMUM KIDNEY CARE SC is a nephrology internal medicine in Chicago, IL. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. OPTIMUM KIDNEY CARE SC NPI is 1306893797. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

331 W SURF ST STE 703
CHICAGO, IL
ZIP 60657-227
Phone: (773) 525-4701
Fax: (773) 326-3539

The provider's authorized official is Mohamed Medhat Salem .
The authorized official title is President and has the following contact phone number (773) 525-4701.

The enumeration date for this NPI number is 5/30/2006 and was last updated on 4/9/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RN0300X	Internal Medicine	Nephrology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DE4201	OTHER	ILLINOIS	RAILROAD MEDICARE
2	151011	OTHER	ILLINOIS	ADVOCATE HLTH PARTNERS ID
3	01636011	OTHER	ILLINOIS	BCBS PROVIDER ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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