Saint Margaret Mercy Dialysis Centers, LLC

Primary specialty

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

Legal business name

SAINT MARGARET MERCY DIALYSIS CENTERS, LLC

Doing business as

East Chicago Dialysis Center

Practice address

1207 E Chicago Ave # 19
East Chicago, IN 46312-6517

Phone

(219) 397-7751

NPI assigned

Aug 20, 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

• EAST CHICAGO DIALYSIS CENTER Doing business as

Locations

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568577302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 E CHICAGO AVE # 19",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463126517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 E CHICAGO AVE # 19",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463126517",
            "telephone_number": "219-397-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MARGARET MERCY DIALYSIS CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "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": "EAST CHICAGO DIALYSIS CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaime E Ruiz Montero, MD
• Krystal Yvonne Runyon
• Yesenia Rybarski, MHS, CCC-SLP
• Kathryn June Rys
• Ahmed Sabry, M.D
• Kelly Ann Salazar, FNP
• Selena Samardzich, FNP
• Sams Place 78 LLC
• Berenis Sandoval
• Epifanio Gloria Sandoval, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in East Chicago, IN
• Providers in East Chicago, IN by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Indiana

• 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.