| NPI | 1760046064 |
|---|---|
| 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 | 2019-04-23 |
| Last Update Date | 2019-05-10 |