| NPI | 1356468409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LEE MULL Director Of Patient Accounts 815-300-7139 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: IL 1706432) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2012-02-08 |