1750570685 NPI number — MIDWEST NEPHROLOGY CONSULTANTS S.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750570685 NPI number — MIDWEST NEPHROLOGY CONSULTANTS S.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDWEST NEPHROLOGY CONSULTANTS S.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750570685
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4050 HEALTHWAY DR
Provider Second Line Business Mailing Address:
SUITE# 200
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60504-8183
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-499-4795
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4050 HEALTHWAY DR
Provider Second Line Business Practice Location Address:
SUITE# 200
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60504-8183
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-499-4795
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
QAMAR - ROHAIL
Authorized Official First Name:
HUMA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
630-499-4795

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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