Fresenius Medical Care of Illinois, LLC

Primary specialty

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

Legal business name

FRESENIUS MEDICAL CARE OF ILLINOIS, LLC

Practice address

624 Voris-Jost Dr.
Waterloo, IL 62298-1568

Phone

(618) 939-6156

Fax

(618) 939-6158

NPI assigned

Jan 23, 2015

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

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

Authorized official

Name

Mr. Mark R Fawcett

Title

SVP & Treasurer

Phone

(781) 699-9000

Specialties & licenses 1

Addresses

Other names 1

• Fresenius Medical Care Waterloo Doing business as

Member of 1

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

• National Medical Care, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bristol, TN
  • NPI 1477570117

  Member Of

  NPD member

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1861882227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 VORIS-JOST DR.",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981568",
            "telephone_number": "618-939-6156",
            "fax_number": "618-939-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 VORIS-JOST DR.",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981568",
            "telephone_number": "618-939-6156",
            "fax_number": "618-939-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESENIUS MEDICAL CARE OF ILLINOIS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "FAWCETT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SVP & TREASURER",
        "authorized_official_telephone_number": "781-699-9000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresenius Medical Care Waterloo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrice L Finch, MHP
• Lewis Fischer, M.D.
• Linda K. Fischer, M.D.
• Foot & Ankle Center, LLC
• Lindsay Forsythe
• Katie Ann Frey, MHP
• Tara Frey, RSA
• Nichole E Friederich, DPT
• Taisha Furlow, RSA
• Dawn Garner, MHP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Waterloo, IL
• Providers in Waterloo, 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 4, 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.