NPIMap

Organization Active NPI

Fresenius Medical Care Comprehensive CKD Services Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Evergreen Park, IL
National Provider Identifier
1457529943
Registry record updated Feb 19, 2008
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 COMPREHENSIVE CKD SERVICES INC
Practice address
9730 S Western Ave
CKD Services of Evergreen Park
Evergreen Park, IL 60805-2814
Phone
(708) 423-8833
Fax
(708) 423-0689
NPI assigned
Feb 19, 2008
Organization subpart
Yes
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Mark Fawcett
Title
Vice President, Treasurer
Phone
(781) 699-2668

Specialties & licenses 1

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

Addresses

Primary practice location

9730 S Western Ave
CKD Services of Evergreen Park
Evergreen Park, IL 60805-2814

Mailing address

920 Winter St
Fmcna CKD Services 3W-16
Waltham, MA 02451-1521
Phone (781) 699-4160

Other names 1

  • CKD Services of Evergreen Park Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fresenius Med Care Comp CKD2 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.

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1457529943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 WINTER ST",
            "address_2": "FMCNA CKD SERVICES 3W-16",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511521",
            "telephone_number": "781-699-4160",
            "fax_number": "781-699-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 S WESTERN AVE",
            "address_2": "CKD SERVICES OF EVERGREEN PARK",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052814",
            "telephone_number": "708-423-8833",
            "fax_number": "708-423-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE COMPREHENSIVE CKD SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS INC",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VICE PRESIDENT, TREASURER",
        "authorized_official_telephone_number": "781-699-2668"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CKD Services of Evergreen Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.