Dialysis Access Center, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Moline, IL
NPI 1578879847 · NPPES record last updated Aug 29, 2014
Key facts
- NPI
- 1578879847
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- DIALYSIS ACCESS CENTER, LLC
- Practice address
- 400 John Deere Rd
Building 2
Moline, IL 61265-6898 - Phone
- (309) 797-0594
- Fax
- (309) 762-5297
- NPI assigned
- Aug 25, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Rajesh Alla, M.D.
- Title
- Medical Director
- Phone
- (309) 762-5570
Practitioners 2
-
Rajesh Alla, M.D.
-
Suresh Alla, M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
400 John Deere Rd
Building 2
Moline, IL 61265-6898
Mailing address
400 John Deere Rd
Building 2
Moline, IL 61265-6898
Phone (309) 797-0594
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IL5611 | Other | IL | MEDICARE PTAN |
| 51756 | Other | IL | BLUE CROSS BLUE SHIELD OF ILLINOIS |
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All providers in Moline, IL · Ambulatory Surgical Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.