Affiliated Dialysis of Joliet LLC

Primary specialty

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

Legal business name

AFFILIATED DIALYSIS OF JOLIET LLC

Doing business as

Morris Community Dialysis

Practice address

1401 Lakewood Dr
Morris, IL 60450-3352

Phone

(630) 942-1111

Fax

(630) 942-1112

NPI assigned

Nov 20, 2015

Last updated

Nov 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tyson Aschliman

Title

Chief Executive Officer

Phone

(309) 698-1800

Specialties & licenses 1

Addresses

Other names 2

• Morris Community Dialysis Doing business as
• Renal Management Group Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Affiliated Dialysis of Joliet LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Joliet, IL
  • NPI 1215365366

  2365678547

  Same PAC ID

Listed as

Affiliated Dialysis of MorrisCCN 142814

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Apr 11, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

10

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.

• Affiliated Dialysis of Joliet LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Joliet, IL
  • NPI 1215365366
  NPD tax ID

Locations

Interoperability endpoints

• Direct secure messaging: tyson.a@rmg.services

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• David L McFadden, M.D.

  • Nephrology Physician
  • Joliet, IL
  • NPI 1033270533

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1386018885",
    "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": "1401 LAKEWOOD DR",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503352",
            "telephone_number": "630-942-1111",
            "fax_number": "630-942-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED DIALYSIS OF JOLIET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "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": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "309-698-1800"
    },
    "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": [
        {
            "organization_name": "Morris Community Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Morris Community Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renal Management Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Morris, IL
• Providers in Morris, 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 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.