Affiliated Dialysis of Joliet LLC
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Joliet, IL
NPI 1215365366 · NPPES record last updated Nov 17, 2020
Key facts
- NPI
- 1215365366
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 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
- Organization subpart
- No
Authorized official
- Name
- Mr. Tyson Aschliman
- Title
- Manager
- Phone
- (847) 894-1951
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Medicare Care Compare: Dialysis facility
- Listed as
- Affiliated Dialysis of Joliet
- Ownership
- Profit
- Certified
- Apr 23, 2014
- Medicare certification status
- Active
- Dialysis stations
- 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131118000371 | IL | Part a Provider - End-Stage Renal Disease Facility (ESRD) | 2365678547 | Practice locations: Joliet, IL |
National Provider Directory
- Tax ID family
- Affiliated Dialysis of Joliet
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tyson.a@rmg.services | Direct |
Other providers in Joliet, IL
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- Advanced Reproductive Health
- Advocate & Consultant Solutions
- Dolly Osas Agba
- Agha Medical Inc
- Kristin Agnew
- Agtel, LLC
- Julisa Aguirre Villagomez
All providers in Joliet, IL · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.