HOME DIALYSIS SERVICE ELGIN LLC NPI 1326388489

NPI Information

NPI: 1326388489
Provider Name: HOME DIALYSIS SERVICE ELGIN LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 14D2108693

Address:
440 N IL ROUTE 31
CRYSTAL LAKE, IL
ZIP 60012
Phone: (224) 238-3211
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HOME DIALYSIS SERVICE ELGIN LLC is an end-stage renal disease (esrd) treatment clinic center in Crystal Lake, IL. HOME DIALYSIS SERVICE ELGIN LLC NPI is 1326388489. The provider is registered as an organization entity type.

The provider's business location address is:

440 N IL ROUTE 31
CRYSTAL LAKE, IL
ZIP 60012-709
Phone: (224) 238-3211
Fax: (224) 535-8215

The provider's authorized official is Morufu Alausa .
The authorized official title is Medical Director and has the following contact phone number (815) 741-6830.

The CLIA number assigned to this NPI record is 14D2108693 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/26/2013 and was last updated on 10/5/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment		ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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