Usrc Hickory Hills. LLC

Primary specialty

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

Legal business name

USRC HICKORY HILLS. LLC

Doing business as

US Renal Care Hickory Hills Dialysis

Practice address

9640 S Roberts Rd Ste 3-Ba
Hickory Hills, IL 60457-2238

Phone

(708) 459-9598

Fax

(708) 459-9035

NPI assigned

Jul 7, 2017

Last updated

Jul 27, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

US 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

Chairman, Authorized Official

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other names 1

• US RENAL CARE HICKORY HILLS DIALYSIS Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Usrc Hickory Hills DialysisCCN 142830

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Feb 6, 2018

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.

• Priya Bhatia Raju, MD

  • Nephrology Physician
  • Evergreen Park, IL
  • NPI 1144476912

  Dialysis facility

  Care Compare affiliation Name & address match
• Natalie M Selk, MD

  • Nephrology Physician
  • Evergreen Park, IL
  • NPI 1881851400

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501113600000",
    "number": "1538681986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251549",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251500",
            "telephone_number": "214-736-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 S ROBERTS RD STE 3-BA",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "604572238",
            "telephone_number": "708-459-9598",
            "fax_number": "708-459-9035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USRC HICKORY HILLS. LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE, INC.",
        "enumeration_date": "2017-07-07",
        "last_updated": "2017-07-27",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN, AUTHORIZED OFFICIAL",
        "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": "US RENAL CARE HICKORY HILLS DIALYSIS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "US RENAL CARE HICKORY HILLS DIALYSIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anthony Joseph Tisoncik, D.D.S.
• Jelena Tomic
• Kathleen Patricia Torrez
• Trust Shuttle
• Gina Marie Urso
• Phung Van, D.C.
• Guadalupe M Villa
• Benjamin Villafane Jr., LAB TECHNICIAN
• Joanna Voutiritsas, PHARM.D.
• Walgreen Co (Walgreens #05684)

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hickory Hills, IL
• Providers in Hickory Hills, 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 Jul 27, 2017; 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.