Dialysis Centers of America - Illinois, Inc.

Primary specialty

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

Legal business name

DIALYSIS CENTERS OF AMERICA - ILLINOIS, INC.

Doing business as

RCG CENTRAL ILLINOIS-BLOOMINGTON

Practice address

1505 Eastland Medical Plaza
Lower Level
Bloomington, IL 61701

Phone

(309) 663-7165

NPI assigned

Aug 22, 2006

Organization subpart

No

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) 402-9000

Specialties & licenses 1

Addresses

Other names 1

• RCG CENTRAL ILLINOIS-BLOOMINGTON Doing business as

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467568394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND MEDICAL PLAZA",
            "address_2": "LOWER LEVEL",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND MEDICAL PLAZA",
            "address_2": "LOWER LEVEL",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61701",
            "telephone_number": "309-663-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIALYSIS CENTERS OF AMERICA - ILLINOIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "781-402-9000"
    },
    "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": "RCG CENTRAL ILLINOIS-BLOOMINGTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dewitt Livingston Logan McLean Regional Office of Education #17
• Shweta Dey
• Rubina Dhillon
• Diagnostic Neuro Technology, LLC
• Melinda Sue Dial, FNP
• Dialysis Centers of America - Illinois, Inc.
• Herman Justis Dick Jr., M.D.
• Chad Dickey
• Mazzy J Dicriscio
• Debra Dietrich, PSYCHOLOGIST

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bloomington, IL
• Providers in Bloomington, 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 Aug 22, 2020; 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.