NPIMap

Organization Active NPI

Affiliated Dialysis of Joliet LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Joliet, IL
National Provider Identifier
1215365366
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
AFFILIATED DIALYSIS OF JOLIET LLC
Practice address
1352 Houbolt Rd
Joliet, IL 60431-9215
Phone
(630) 942-1111
Fax
(630) 942-1112
NPI assigned
Oct 29, 2013
Last updated
Nov 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Authorized official

Name
Mr. Tyson Aschliman
Title
Manager
Phone
(847) 894-1951

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1352 Houbolt Rd
Joliet, IL 60431-9215

Mailing address

2462 Washington Rd
Washington, IL 61571-1756
Phone (309) 698-1800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tyson.a@rmg.services Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131118000371 IL Part A Provider - End-Stage Renal Disease Facility (ESRD) 2365678547 Practice locations: Joliet, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Affiliated Dialysis of JolietCCN 142773
Ownership
Profit
Certified
Apr 23, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
1

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Affiliated Dialysis of Joliet2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

800 Roosevelt Rd
Ste E320
Glen Ellyn, IL 60137
Phone (630) 942-1111

NPI Registry JSON

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1215365366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2462 WASHINGTON RD",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615711756",
            "telephone_number": "309-698-1800",
            "fax_number": "309-713-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1352 HOUBOLT RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604319215",
            "telephone_number": "630-942-1111",
            "fax_number": "630-942-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED DIALYSIS OF JOLIET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "ASCHLIMAN",
        "authorized_official_first_name": "TYSON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-894-1951",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyson.a@rmg.services",
            "affiliation": "N",
            "endpointDescription": "RMG email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2462 Washington Rd",
            "city": "Washington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "615711756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.