Perryton Dialysis LLC

Primary specialty

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

Legal business name

PERRYTON DIALYSIS LLC

Practice address

8604 Woodward Ave
Woodridge, IL 60517-3171

Phone

(331) 260-9226

Fax

(331) 260-9244

NPI assigned

Nov 22, 2019

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, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other names 1

• Rutgers Park Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

DaVita Rutgers Park DialysisCCN 142869

Overall star rating

2.0 of 5

Ownership

Profit

Certified

May 27, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

12

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Lisle, IL
  • NPI 1679811095

  Member Of

  NPD member
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockfrd, IL
  • NPI 1154997591

  Member Of

  NPD member

Locations

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Kristie Lynn Slivka Delaney, M.D.

  • Nephrology Physician
  • Winfield, IL
  • NPI 1295026441

  Dialysis facility

  Care Compare affiliation Name & address match
• Ali Imtiaz

  • Nephrology Physician
  • Naperville, IL
  • NPI 1972036010

  Dialysis facility

  Care Compare affiliation Name & address match
• Shivani Shah, M.D.

  • Nephrology Physician
  • Naperville, IL
  • NPI 1982837779

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1730725904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "ATT: L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8604 WOODWARD AVE",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605173171",
            "telephone_number": "331-260-9226",
            "fax_number": "331-260-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRYTON DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-22",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "VP, LICENSURE & 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": "Rutgers Park Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rutgers Park Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Umang S Patel, M.D
• Vijaykumar C Patel,, M.D
• Elizabeth A Paterson, ATC
• Ann Pebelske, APN CNS
• Pediatrics of Woodridge
• Evagelia Peterhansen, OTRL
• Rachel H Peterson, M.S.
• Taylor Marie Philipp, DPT
• Lemuel Bryan Phipps, PHARMD
• Physicians C.a.R.E. Midwest, S.C.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Woodridge, IL
• Providers in Woodridge, 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 5, 2025; 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.