Elgin Nephrology Associates., S.C.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

ELGIN NEPHROLOGY ASSOCIATES., S.C.

Practice address

296 W Spring St
South Elgin, IL 60177-1534

Phone

(847) 697-2692

NPI assigned

Aug 21, 2006

Organization subpart

No

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

Authorized official

Name

Mary M Petkovic

Title

Office Manager

Phone

(847) 697-2692

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962518449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 W SPRING ST",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601771534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 W SPRING ST",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "601771534",
            "telephone_number": "847-697-2692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELGIN NEPHROLOGY ASSOCIATES., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETKOVIC",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-697-2692"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Difulvio, RBT
• Allison Kay Dillenburg, PT, DPT
• Quang H Dinh, PHARM. D
• Stephen Herre Echsner Jr., MD
• Mariam Elghorr, RPH
• Elgin Primary Care
• Karen Erickson
• Julie Errico, PHARMD
• Kate S Evans, LCPC
• Evergreen Medical Group SC

• Specialist in South Elgin, IL
• Providers in South Elgin, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.