NPIMap

Organization Active NPI

Diamond Dialysis Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Chicago, IL
National Provider Identifier
1659374247
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
DIAMOND DIALYSIS INC.
Practice address
9415 S Western Ave
Ste 105
Chicago, IL 60620-6232
Phone
(773) 238-5200
Fax
(773) 238-5527
NPI assigned
May 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Edwin S. Nunez
Title
Administrator
Phone
(773) 238-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

9415 S Western Ave
Ste 105
Chicago, IL 60620-6232

Mailing address

9415 S Western Ave
Ste 105
Chicago, IL 60620-6232
Phone (773) 238-5200

Other identifiers 1

IdentifierTypeStateIssuer
1633535OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

9415 S Western Ave
Ste 105
Chicago, IL 60643
Phone (773) 238-5200

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659374247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9415 S WESTERN AVE",
            "address_2": "STE 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606206232",
            "telephone_number": "773-238-5200",
            "fax_number": "773-238-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 S WESTERN AVE",
            "address_2": "STE 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606206232",
            "telephone_number": "773-238-5200",
            "fax_number": "773-238-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND DIALYSIS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NUNEZ",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "773-238-5200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1633535",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • 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.