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

Grundy Center Dialysis

Practice address

101 E J Ave
Grundy Center, IA 50638-2031

Phone

(319) 825-4730

Fax

(319) 825-4733

NPI assigned

Feb 26, 2010

Last updated

Sep 18, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James K Hilger

Title

Chief Accounting Officer

Phone

(253) 733-4500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grundy Center Dialysis Doing business as

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1710209127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-341-6657",
            "fax_number": "866-651-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E J AVE",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506382031",
            "telephone_number": "319-825-4730",
            "fax_number": "319-825-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS ILLINOIS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-26",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4500"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710209127",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grundy Center Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric F Opheim, DO
• Jean Marie Osgood, ARNP
• Crystal Lynn Petersen, RDN, LD
• Valorie Jean Prahl, D.C
• Premier Estates 504, LLC (Grundy Care Center)
• RJ Weaver PLLC (Grundy Center Family Dental)
• Stefanie L Rohler, OD
• Whitney Lynne Schipper, LMSW
• Dana Christopher Schmidt, DPT
• Gabriel Lee Smith, DC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Grundy Center, IA
• Providers in Grundy Center, IA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.