| NPI | 1265903876 |
|---|---|
| Other Name | DIALYZE DIRECT IL - GLEN ELLYN |
| Entity Type | Organization |
| Authorized Contact | JOSHUA ROTHENBERG Chief Operating Officer 732-806-9968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2018-12-07 |
| Last Update Date | 2019-09-17 |