Renal Treatment Centers-Illinois, Inc

Primary specialty

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

Legal business name

RENAL TREATMENT CENTERS-ILLINOIS, INC

Doing business as

Manteno Dialysis

Practice address

1 E Division St
Manteno, IL 60950-1507

Phone

(815) 468-1000

Fax

(815) 468-7271

NPI assigned

Dec 17, 2018

Organization subpart

No

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

Authorized official

Name

Samuel Wey

Title

VP Licensing & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other names 1

• Manteno Dialysis Doing business as

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1699246504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPARTMENT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4514",
            "fax_number": "866-594-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E DIVISION ST",
            "city": "MANTENO",
            "state": "IL",
            "postal_code": "609501507",
            "telephone_number": "815-468-1000",
            "fax_number": "815-468-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS-ILLINOIS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP LICENSING & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manteno Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Manteno Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pinnacle Gastroenterology SC
• Prairie Rock Foot & Ankle Clinic LTD
• Premier Family Dental
• Tamara Kay Reif, MA
• John Carl Reiniche
• Helen Riberdy
• Kara Riedstra, M.ED., CCC-SLP
• Beth Rogers, CNP
• Amy Romero
• Andrea C Rorabaugh, FNP-BC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Manteno, IL
• Providers in Manteno, 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 Nov 6, 2023; 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.