NPIMap

Organization Active NPI

SRS-Chicago Circle, LLC

Doing business as SRS Dialysis of Chicago

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chicago, IL
National Provider Identifier
1497402770
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SRS-CHICAGO CIRCLE, LLC
Doing business as
SRS Dialysis of Chicago
Practice address
1426 W Washington Blvd
Chicago, IL 60607-1821
Phone
(615) 467-0140
Fax
(615) 259-0693
NPI assigned
Mar 7, 2022
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Dr. Jerome S Tannenbaum, M.D., PH.D., FACPNPI 1346485638
Title
Ceo
Phone
(615) 467-0140

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1426 W Washington Blvd
Chicago, IL 60607-1821

Mailing address

PO Box 198813
Nashville, TN 37219-8813
Phone (615) 988-7881

Other names 1

  • SRS Dialysis of Chicago Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230602000190 IL Part A Provider - End-Stage Renal Disease Facility (ESRD) 2466819636 Practice locations: Chicago, IL

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Circle Medical ManagementCCN 142540
Overall star rating
1.0 of 5
Ownership
Profit
Certified
Jan 12, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Dialysis stations
28

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory

Locations

140 S Ashland Ave
Chicago, IL 60607
Phone (312) 829-1424

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1497402770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198813",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372198813",
            "telephone_number": "615-988-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 W WASHINGTON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071821",
            "telephone_number": "615-467-0140",
            "fax_number": "615-259-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRS-CHICAGO CIRCLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-07",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "TANNENBAUM",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-467-0140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D., FACP"
    },
    "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": "SRS Dialysis of Chicago",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SRS Dialysis of Chicago",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.