RENAL TREATMENT CENTERS ILLINOIS INC NPI 1073558904

NPI Information

RENAL TREATMENT CENTERS ILLINOIS INC is an end-stage renal disease (esrd) treatment clinic center in Andover, OH. RENAL TREATMENT CENTERS ILLINOIS INC NPI is 1073558904. The provider is registered as an organization entity type.
The provider Is Doing Business As Andover Dialysis.

The provider's business location address is:

488 S MAIN ST
ANDOVER, OH
ZIP 44003-602
Phone: (440) 293-6028
Fax: (440) 293-6219

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 36D1058599 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/17/2006 and was last updated on 5/18/2021.

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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