Excel Kidney Care LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

EXCEL KIDNEY CARE LLC

Practice address

3002 N Ashland Ave
Chicago, IL 60657-3012

Phone

(773) 296-3003

Fax

(773) 296-3002

NPI assigned

Jun 18, 2015

Organization subpart

No

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

Authorized official

Name

Abdul Mubeen Mohammed, MD

Title

Ceo

Phone

(281) 853-4429

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Nestor Dante Verano, APRN, AGNP-C

  • Gerontology Nurse Practitioner
  • Chicago, IL
  • NPI 1679128144
  Medicare reassignment Care Compare group NPD
• Mohammed A Mubeen, M.D.,

  • Hospitalist Physician
  • Chicago, IL
  • NPI 1578720777
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463788800000",
    "number": "1457733180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68698",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601680698",
            "telephone_number": "773-296-3003",
            "fax_number": "773-296-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3002 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573012",
            "telephone_number": "773-296-3003",
            "fax_number": "773-296-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL KIDNEY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2016-05-21",
        "status": "A",
        "authorized_official_last_name": "MOHAMMED",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_middle_name": "MUBEEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-853-4429",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "C81662",
            "identifier": "HEALTHLINK",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457733180",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "7642518",
            "identifier": "7642518",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nia Ewing
• Pamela Evette Ewing
• Dametria Lynn Ewunes, PSYD
• Aidan Marie Ex-Willey, PA-C
• Exactly Health LLC
• Excel Renal Care Services LLC
• Daron Excel
• Excell at Home
• Excell Home Health Services, Inc
• Kamaria Gye Nyame Excell, LSW

• Nephrology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.