MACHESNEY BAY DIALYSIS LLC NPI 1033658349

NPI Information

MACHESNEY BAY DIALYSIS, LLC is an end-stage renal disease (esrd) treatment clinic center in Rockford, IL. MACHESNEY BAY DIALYSIS, LLC NPI is 1033658349. The provider is registered as an organization entity type.
The provider Is Doing Business As Forest City Dialysis.

The provider's business location address is:

198 N SPRINGFIELD AVE
ROCKFORD, IL
ZIP 61101-086
Phone: (815) 962-8914
Fax: (815) 962-8952

The provider's authorized official is John D Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 14D2135690 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/20/2017 and was last updated on 5/16/2020.

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:

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