| NPI | 1922385558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL HIZON Manager 815-937-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: IL applied for) |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2011-11-10 |