NPIMap

Organization Active NPI

Fresenius Medical Care of Illinois, LLC

Doing business as Fresenius Medical Care Roseland

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chicago, IL
National Provider Identifier
1376726497
Registry record updated May 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
FRESENIUS MEDICAL CARE OF ILLINOIS, LLC
Doing business as
Fresenius Medical Care Roseland
Practice address
132 W. 111TH Street
Chicago, IL 60628-4215
Phone
(773) 995-1783
NPI assigned
Dec 12, 2007
Last updated
May 20, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2013

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

Authorized official

Name
Mark Fawcett
Title
Treasurer
Phone
(781) 699-9000

Specialties & licenses 1

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

Addresses

Primary practice location

132 W. 111TH Street
Chicago, IL 60628-4215

Mailing address

132 W. 111TH Street
Chicago, IL 60628-4215
Phone (773) 995-1783

Other names 1

  • Fresenius Medical Care Roseland Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369008000000",
    "number": "1376726497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 W. 111TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284215",
            "telephone_number": "773-995-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 W. 111TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284215",
            "telephone_number": "773-995-1783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE OF ILLINOIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2007-12-12",
        "last_updated": "2013-05-20",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "781-699-9000"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresenius Medical Care Roseland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; 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.