Usrc Bolingbrook LLC

Primary specialty

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

Legal business name

USRC BOLINGBROOK LLC

Doing business as

U.S. Renal Care Bolingbrook Dialysis

Practice address

396 Remington Blvd
Ste 110
Bolingbrook, IL 60440-4302

Phone

(630) 759-1943

Fax

(630) 759-2314

NPI assigned

May 24, 2012

Last updated

Oct 25, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

U.S. RENAL CARE, INC.As reported in NPPES

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

Authorized official

Name

Thomas L. Weinberg

Title

Authorized Representative

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• U.S. Renal Care Bolingbrook Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Usrc BolingbrookCCN 142749

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Jan 7, 2013

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

13

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

US Renal Care Inc

Locations

Affiliated clinicians 2

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

• Mohammed Shujauddin Ahmed, D.O.

  • Nephrology Physician
  • Bolingbrook, IL
  • NPI 1962588061

  Dialysis facility

  Care Compare affiliation Name & address match
• Huma Q. Rohail, M.D.

  • Nephrology Physician
  • Bolingbrook, IL
  • NPI 1164402335

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1497015390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19119",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724036601",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 REMINGTON BLVD",
            "address_2": "STE 110",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404302",
            "telephone_number": "630-759-1943",
            "fax_number": "630-759-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC BOLINGBROOK LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "U.S. RENAL CARE, INC.",
        "enumeration_date": "2012-05-24",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "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": "U.S. Renal Care Bolingbrook Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evelyn Ukpolo, PMHNP
• Ulezi LLC
• Catherine A Unger, PHARMD
• Fernando Rey Urzua, DDS
• Ferdinand Uson, P.T
• Usv Optical Inc.
• Alondra G Valdez Huziar
• Rachelle Mae S Valenzuela, PA
• Denise Valero Ficht, M.D.
• Lisa Ann Valiente, LCSW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bolingbrook, IL
• Providers in Bolingbrook, 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 Oct 25, 2013; 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.