NPI | 1154073278 |
---|---|
Entity Type | Organization |
Authorized Contact | MORUFU OLATUNJI ALAUSA Medical Director 815-741-6830 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
Enumeration Date | 2022-01-20 |
Last Update Date | 2022-01-20 |