Ingalls Dialysis Center

Primary specialty

Chronic Disease HospitalTaxonomy code 281P00000X

Legal business name

INGALLS DIALYSIS CENTER

Practice address

2930 Montvale Dr Ste B
Springfield, IL 62704-5376

Phone

(708) 552-0325

NPI assigned

Feb 8, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Simon P Williamson II, MD

Title

Head Charge Physician

Phone

(708) 552-0325

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1581120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1801428701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 MONTVALE DR STE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045376",
            "telephone_number": "708-552-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 MONTVALE DR STE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045376",
            "telephone_number": "708-552-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGALLS DIALYSIS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-08",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "HEAD CHARGE PHYSICIAN",
        "authorized_official_telephone_number": "708-552-0325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "281P00000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independence Holding Co LLC
• Independence Holding Co LLC
• Aishwarya Indiramohan, DDS
• Mastan Rao Indlamuri, M.D.,
• Infinity-Meds LLP
• Laura Beth Ingalsbe, RN
• Dordana Elizabeth Ingram, LCSW
• Kathryn Ingram, BCBA
• Ingrid I. Alexander, MD, PC
• Inner Health Spa LLC

• All providers in Springfield, IL
• Chronic Disease Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.