Dialysis at Home

Primary specialty

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

Legal business name

DIALYSIS AT HOME

Practice address

11638 S Western Ave
Chicago, IL 60643-4730

Phone

(224) 735-3638

NPI assigned

Feb 16, 2015

Organization subpart

No

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

Authorized official

Name

Shahida M Khan

Title

Owner

Phone

(847) 401-6079

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1265823918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11638 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434730",
            "telephone_number": "224-735-3638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11638 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434730",
            "telephone_number": "224-735-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS AT HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SHAHIDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-401-6079"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariam Diallo Fofana, FNP-BC
• Mamadou Kindy Cherif Diallo, MD
• Reneau Alberta Diallo, CNM APN
• Souleymane Diallo, DPM
• Dialogue to Wellness
• Dialysis Care Center Beverly LLC
• Dialysis Centers of America - Illinois, Inc.
• Dialysis Centers of America - Illinois, Inc.
• Dialysis Centers of America - Illinois, Inc.
• Dialysis Centers of America - Illinois, Inc.

• 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 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.