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FOX VALLEY DIALYSIS LTD NPI 1912900192


NPI Information

NPI: 1912900192
Provider Name: FOX VALLEY DIALYSIS LTD
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 14D0888115

Address:
1300 WATERFORD DR
AURORA, IL
ZIP 60504
Phone: (630) 236-1300
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FOX VALLEY DIALYSIS LTD is an end-stage renal disease (esrd) treatment clinic center in Aurora, IL. FOX VALLEY DIALYSIS LTD NPI is 1912900192. The provider is registered as an organization entity type.

The provider's business location address is:

1300 WATERFORD DR
AURORA, IL
ZIP 60504-502
Phone: (630) 236-1300

The provider's authorized official is Calvin Ganong .
The authorized official title is Chief Operating Officer and has the following contact phone number (630) 851-1206.

The CLIA number assigned to this NPI record is 14D0888115 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/23/2005 and was last updated on 8/22/2020.


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:

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
1644OTHERILLINOISBLUE CROSS PROVIDER NUMBE

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.