Western Illinois Kidney Center

Primary specialty

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

License

001 Issued in IL

Legal business name

WESTERN ILLINOIS KIDNEY CENTER

Practice address

765 N Kellogg St
Suite 101
Galesburg, IL 61401-2875

Phone

(309) 345-4580

Fax

(309) 345-4581

NPI assigned

Jan 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Partha Srinivasan, M.D

Title

Ceo & Medical Director

Phone

(309) 345-4580

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Parthasarathy Srinivasan, M.D.

  • Nephrology Physician
  • Galesburg, IL
  • NPI 1134199359
  NPD

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609856640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 N KELLOGG ST",
            "address_2": "SUITE 101",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012875",
            "telephone_number": "309-345-4580",
            "fax_number": "309-345-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 N KELLOGG ST",
            "address_2": "SUITE 101",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012875",
            "telephone_number": "309-345-4580",
            "fax_number": "309-345-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN ILLINOIS KIDNEY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SRINIVASAN",
        "authorized_official_first_name": "PARTHA",
        "authorized_official_title_or_position": "CEO & MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "309-345-4580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "IL",
            "license": "001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matt Wells, MHP
• Welty Dental LLC
• Adam Christian Welty, D.M.D.
• Tommy Lynn West, M.D.
• Western Illinois Cancer Treatment Center (InterCommunity Cancer Center of Western Illinois)
• Western Illinois Managed Home Services, Inc.
• Western Illinois Oral & Maxillofacial Surgery, LTD.
• Meagan Wheeler, PT
• Jesse Wheelhouse, MHP
• Jill D Whiteside, CRNA

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Galesburg, IL
• Providers in Galesburg, 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 21, 2022; 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.