Illinois Kidney Care PLLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

ILLINOIS KIDNEY CARE PLLC

Practice address

3023 N Clark St #302
Chicago, IL 60657

Phone

(312) 767-7811

NPI assigned

Apr 18, 2019

Last updated

May 28, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daniel RosemanNPI 1952530032

Title

Manager

Phone

(312) 767-7811

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Roseman, M.D.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1952530032

  IL

  Medicare reassignment NPD Authorized official
• Kireet Agrawal, MD

  • Nephrology Physician
  • Chicago, IL
  • NPI 1780831719
  Medicare reassignment NPD
• Laine Mercedes Lee Nunez, NURSE PRACTITIONER

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1245800424
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559001600000",
    "number": "1154984755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 N CLARK ST #302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "312-767-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 N CLARK ST #302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "312-767-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS KIDNEY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-05-28",
        "status": "A",
        "authorized_official_last_name": "ROSEMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "312-767-7811"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Illinois Home Hospice & Palliative Care Inc
• Illinois Homecare and Training, Inc.
• Illinois Imaging, Inc.
• Illinois Institute for Integrative Mental Health LTD
• Illinois Institute of Gynecology and Advanced Pelvic Surgery, SC
• Illinois Masonic Hospital
• Illinois Medical Care and Consulting, LLC
• Illinois Medical Care LTD
• Illinois Medical Group SC
• Illinois Medical Specialists PC

• Nephrology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.