<Unavail>

LBN: Usrc Villa Park, Llc
<Unavail> is an health care organization with primary practice located at 200 E North Ave , Villa Park IL 60181-1221. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Usrc Villa Park, Llc can be contacted via phone (630) 530-5237, or through Weinberg, Thomas L. via phone (214) 736-2700.

Contact Information

Primary practice address
200 E North Ave Villa Park IL 60181-1221
Phone: (630) 530-5237
Fax: (630) 530-5242
Website:
Map and Directions
Authorized official contact:
Name: Weinberg, Thomas L.
Phone: (214) 736-2700

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1093067415
LBN Legal business name Usrc Villa Park, Llc
DBA Doing business as <Unavail>
Authorized official Weinberg, Thomas L.
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 9th, 2012
Last updated Feb 6th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093067415 NPPES
Illinois MEDICAID 511682658001

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