DIALYSIS CARE CENTER HAZEL CREST LLC NPI 1376199190

NPI Information

NPI: 1376199190
Provider Name: DIALYSIS CARE CENTER HAZEL CREST LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 14D2165705

Address:
18325 PULASKI AVE UNIT A-B
HAZEL CREST, IL
ZIP 60429
Phone: (708) 824-7900
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DIALYSIS CARE CENTER HAZEL CREST LLC is an end-stage renal disease (esrd) treatment clinic center in Hazel Crest, IL. DIALYSIS CARE CENTER HAZEL CREST LLC NPI is 1376199190. The provider is registered as an organization entity type.

The provider's business location address is:

18325 PULASKI AVE UNIT A-B
HAZEL CREST, IL
ZIP 60429-480
Phone: (708) 824-7900

The provider's authorized official is Morufu Olatunji Alausa .
The authorized official title is Chief Medical Director and has the following contact phone number (815) 741-6830.

The CLIA number assigned to this NPI record is 14D2165705 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/16/2019 and was last updated on 8/22/2019.

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	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

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: 5/5/2024

NPI Synchronization or Removal

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