MIDWEST NEPHROLOGY GROUP LLC NPI 1598824492

NPI Information

NPI: 1598824492
Provider Name: MIDWEST NEPHROLOGY GROUP, LLC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
101 WEST 2ND STREET
DIXON, IL
ZIP 61021
Phone: (815) 284-0555
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MIDWEST NEPHROLOGY GROUP, LLC is a nephrology internal medicine in Dixon, IL. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. MIDWEST NEPHROLOGY GROUP, LLC NPI is 1598824492. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

101 WEST 2ND STREET
DIXON, IL
ZIP 61021-053
Phone: (815) 284-0555
Fax: (815) 284-0580

The provider's authorized official is Venkateswararao Alla .
The authorized official title is Medical Directore and has the following contact phone number (815) 284-0555.

The enumeration date for this NPI number is 12/6/2006 and was last updated on 3/4/2009.

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	207RN0300X	Internal Medicine	Nephrology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036056049	MEDICAID	ILLINOIS
2	209482	MEDICARE ID-TYPE UNSPECIFIED
3	036103114	MEDICAID	ILLINOIS
4	036114547	MEDICAID	ILLINOIS
5	05232009	OTHER	ILLINOIS	BCBS
6	G64184	MEDICARE UPIN
7	C51894	MEDICARE UPIN

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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