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WELLBOUND OF EVANSTON LLC NPI 1528140712


NPI Information

NPI: 1528140712
Provider Name: WELLBOUND OF EVANSTON LLC

Doing Business As: WELLBOUND OF EVANSTON

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
8950 GROSS POINT RD
SKOKIE, IL
ZIP 60077
Phone: (847) 965-1901
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WELLBOUND OF EVANSTON LLC is an end-stage renal disease (esrd) treatment clinic center in Skokie, IL. WELLBOUND OF EVANSTON LLC NPI is 1528140712. The provider is registered as an organization entity type.
The provider Is Doing Business As Wellbound Of Evanston.

The provider's business location address is:

8950 GROSS POINT RD
SKOKIE, IL
ZIP 60077-860
Phone: (847) 965-1901
Fax: (847) 965-1952

The provider's authorized official is Susan L Del Bene .
The authorized official title is Secretary/cfo and has the following contact phone number (650) 404-3618.

The enumeration date for this NPI number is 10/19/2006 and was last updated on 12/29/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========001MEDICAIDILLINOIS
2142687MEDICARE OSCAR/CERTIFICATIONILLINOIS

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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