Western Illinois Kidney Center

NPI 1609856640 - Clinic/Center - 261QE0700X

NPI Details
NPI 1609856640
Enumeration Date 01/17/2006
Last Updated 09/08/2011
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name PARTHA PARTHA
Position CEO & MEDICAL DIRECTOR
Phone (309) 345-4580
Fax (309) 345-4581
Practice Location
765 N KELLOGG ST
SUITE 101
GALESBURG IL, 61401-2875, US
Phone (309) 345-4580
Fax (309) 345-4581
Business Location
765 N KELLOGG ST
SUITE 101
GALESBURG IL, 61401-2875, US
Phone (309) 345-4580
Fax (309) 345-4581
Toxanomy
Taxonomy Code 261QE0700X
License State Illinois
License Number =========001
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According to our database, Western Illinois Kidney Center NPI is 1609856640, taxonomy code is 261QE0700X and license number is =========001, license state is located at Illinois. Western Illinois Kidney Center physically located at 765 N Kellogg St, Galesburg IL, 61401-2875. NPI Number 1033115704 has the healthcare provider type.

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1609856640 NPI number is provided on an as is basis without warranty of any kind. 1609856640 is maintained by the National Plan & Provider Enumeration System. The contents of Western Illinois Kidney Center are for informational purposes only.