EAST OAKS DIALYSIS LLC NPI 1629697917

NPI Information

EAST OAKS DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Chicago, IL. EAST OAKS DIALYSIS LLC NPI is 1629697917. The provider is registered as an organization entity type.
The provider Is Doing Business As Marshall Square Dialysis.

The provider's business location address is:

2950 W 26TH ST
CHICAGO, IL
ZIP 60623
Phone: (615) 238-3136

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 14D2186249 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/16/2020 and was last updated on 8/12/2021.

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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