Kidney Care at Home LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

KIDNEY CARE AT HOME LLC

Practice address

3445 N Central Ave
Chicago, IL 60634-4420

Phone

(630) 748-9407

NPI assigned

Mar 12, 2020

Organization subpart

No

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

Authorized official

Name

Kareem M Syed Shah, RN

Title

Unit Director

Phone

(630) 748-9407

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Kidney Care at Home LLCCCN 142881

Ownership

Profit

Certified

Sep 15, 2023

Dialysis stations

1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wasay Humayun, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1013154327
  NPD
• Mustafa Mohammed Ali, M.D.

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1184857138
  NPD
• Victor Aleksander Forys, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1669585857
  NPD (past)
• Hamid M Humayun, MD

  • Nephrology Physician
  • Chicago, IL
  • NPI 1275550964
  NPD (past)
• Patricia Herico Roy, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1598031783
  NPD (past)

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583971200000",
    "number": "1235765017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344420",
            "telephone_number": "630-748-9407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CARE AT HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A",
        "authorized_official_last_name": "SYED SHAH",
        "authorized_official_first_name": "KAREEM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "UNIT DIRECTOR",
        "authorized_official_telephone_number": "630-748-9407",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Kidder, NP
• George Ghassan Issa Kidess
• Anjum Kidiwala
• Kidnetics Inc.
• Kidney and Hypertension Consultants, S.C.
• Kidney Care Center North Chicago LLC
• Kidney Specialists of Illinois LLC
• Mary Kidney, LCSW
• Kids Above All Illinois
• Kids Above All Illinois

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.