Axolotl, LLC
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Harrisburg, IL
NPI 1609136019 · NPPES record last updated May 18, 2012
Key facts
- NPI
- 1609136019
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- Legal business name
- AXOLOTL, LLC
- Practice address
- 130 E Clark St
Harrisburg, IL 62946-2700 - Phone
- (618) 922-9952
- NPI assigned
- May 18, 2012
- Organization subpart
- No
Authorized official
- Name
- Kevin Chen
- Title
- Owner
- Phone
- (618) 922-9952
Practitioners 1
-
Kevin C Chen, MD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Yes |
Addresses
Primary practice location
130 E Clark St
Harrisburg, IL 62946-2700
Mailing address
1507 Gleneagle Dr
Marion, IL 62959-5231
Other providers in Harrisburg, IL
- Assistedcare Group
- Pamela R Atkinson
- Jennifer K Austin
- Axiom Healthcare of Harrisburg LLC
- Axiom Healthcare of Harrisburg LLC
- Angelia Leigh Ayresbennett
- Tiffany Leeann Baird
- Danielle Baker
- Stephan Barnard
- Joseph Baxter
All providers in Harrisburg, IL · End-Stage Renal Disease (ESRD) Treatment 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 May 18, 2012. 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.