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

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
IL5611OtherILMEDICARE PTAN
51756OtherILBLUE CROSS BLUE SHIELD OF ILLINOIS

Other providers in Moline, IL

All providers in Moline, IL · Ambulatory Surgical Clinic/Center in Illinois

Sources for this page

Verify at the official NPI Registry.