OrganizationActive
Cook County
NPI 1831846922 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Chicago, IL
Provider details
- NPI number
- 1831846922
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Cook County
- Organization subpart
- Yes
- Authorized official
- Scott Andrle, Director of Managed Care(312) 864-4649
Specialties & taxonomies
Ambulatory Health Care Facilities
- Renal Dialysis Technician2472R0900X
Technologists, Technicians & Other Technical Service Providers
Practice location
430 East 51st Pl
Chicago, IL 60615
Phone: (312) 864-0200
Approximate (ZIP-level) locationGet directions
Mailing address
430 East 51st Pl
Chicago, IL 60615
Other names (DBA / former)
- Doing business as
- Provident Dialysis Center
- Doing business as
- Provident Dialysis Center
Registry dates
- Enumerated
- 2022-03-08
- Last updated
- 2022-03-16
- Certified
- 2022-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.