CENTRAL ILLINOIS KIDNEY & DIALYSIS ASSOCIATES SC NPI 1598788994

NPI Information

NPI: 1598788994
Provider Name: CENTRAL ILLINOIS KIDNEY & DIALYSIS ASSOCIATES, SC

Other Name: CENTRAL ILLINOIS KIDNEY & DIALYSIS

Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
3401 CONIFER DR
SPRINGFIELD, IL
ZIP 62711
Phone: (217) 726-0967
Get Directions

CENTRAL ILLINOIS KIDNEY & DIALYSIS ASSOCIATES, SC is a nephrology internal medicine in Springfield, 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. CENTRAL ILLINOIS KIDNEY & DIALYSIS ASSOCIATES, SC NPI is 1598788994. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Central Illinois Kidney & Dialysis.

The provider's business location address is:

3401 CONIFER DR
SPRINGFIELD, IL
ZIP 62711-300
Phone: (217) 726-0967
Fax: (217) 726-7633

The provider's authorized official is Stephanie Ann Skinner .
The authorized official title is Office Manager and has the following contact phone number (217) 726-0967.

The CLIA number assigned to this NPI record is 14D0435681 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/26/2006 and was last updated on 3/16/2011.

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	042005163	ILLINOIS	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	687500	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS	PROVIDER NUMBER
2	CM8144	MEDICARE PIN
3	31664	OTHER		GHP GROUP PROVIDER NUMBER
4	8415035	OTHER		BLUE CROSS BLUE SHIELD NU

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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