Nocturnal Dialysis Spa LLC

Primary specialty

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

Legal business name

NOCTURNAL DIALYSIS SPA LLC

Practice address

1634 S Ardmore Ave
Villa Park, IL 60181-3742

Phone

(630) 620-1233

NPI assigned

Jun 9, 2015

Organization subpart

No

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

Authorized official

Name

Kareem Syed Shah

Title

Manager

Phone

(630) 748-9407

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Nocturnal Dialysis SpaCCN 142797

Ownership

Profit

Certified

Aug 15, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

13

Practitioners 1

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

• Hamid M Humayun, MD

  • Nephrology Physician
  • Chicago, IL
  • NPI 1275550964
  NPD (past)

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1669853206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 S ARDMORE AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601813742",
            "telephone_number": "630-620-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 S ARDMORE AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601813742",
            "telephone_number": "630-620-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOCTURNAL DIALYSIS SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "SYED SHAH",
        "authorized_official_first_name": "KAREEM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-748-9407"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malinka Nenova, PHARM. D.
• Kelly Nesbitt, OTR/L
• New Creation Home Care Services,Inc
• New Creation Home Care Services,Inc
• Dao Ngo
• Ivanka Magdalyna Northrop, CF-SLP
• Novak Family Medical Center LLC
• Richard Bogumil Novak, M.D.
• Jennifer Anne Nuter, CCC SLP
• Brittany Marie O'Brien

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Villa Park, IL
• Providers in Villa Park, 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 Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.