NPIMap

Organization Active NPI

Kidney Care Center Elgin LLC

  • Nephrology Physician
  • Crystal Lake, IL
National Provider Identifier
1508126764
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
KIDNEY CARE CENTER ELGIN LLC
Practice address
442 N Il Route 31
Crystal Lake, IL 60012-3709
Phone
(224) 238-3211
Fax
(224) 535-8215
NPI assigned
May 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Authorized official

Name
Dr. Morufu Alausa, MDNPI 1730135955
Title
Medical Director
Phone
(815) 741-6830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

442 N Il Route 31
Crystal Lake, IL 60012-3709

Mailing address

PO Box 3877
Joliet, IL 60434-3877
Phone (815) 741-6830

Other practice location 1

1670 Capital St Unit 900
Elgin, IL 60124-7837
Phone (224) 238-3211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121207000412 IL Part B Supplier - Clinic/Group Practice 2769634252 Receives reassigned benefits from 9 practitioners
Practice locations: Crystal Lake, IL; Elgin, IL

National Provider Directory

National Provider Directory

Locations

1670 Capital St
Ste 900
Elgin, IL 60124
Phone (224) 214-1943

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1508126764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3877",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604343877",
            "telephone_number": "815-741-6830",
            "fax_number": "815-741-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 N IL ROUTE 31",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123709",
            "telephone_number": "224-238-3211",
            "fax_number": "224-535-8215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 Capital St Unit 900",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601247837",
            "country_code": "US",
            "telephone_number": "224-238-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIDNEY CARE CENTER ELGIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "ALAUSA",
        "authorized_official_first_name": "MORUFU",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "815-741-6830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.