MEDICARE: RENAL TREATMENT CENTERS-ILLINOIS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073574794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAL TREATMENT CENTERS-ILLINOIS INC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	L&C DEPT
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 HAMPTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-3115
Country	:	US
Telephone Number	:	314-781-4022
Fax Number	:	314-781-4063

Authorized Official
Title or Position	:	VP LICENSURE & CERTIFICATION
Name	:	SAMUEL T WEY
Credential	:
Telephone Number	:	615-341-6641

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	10/18/2024

Similar Medicare Providers

1659389930 — PAYAL R PATEL MD
Practice Location Address:

1403 HAMPTON AVE
SAINT LOUIS, MO
63139-3115

Practice Phone: 314-955-9355
Practice Fax: 314-955-2187

1992804397 — DR. FARIDA FARZANA MD
Practice Location Address:

3115 HAMPTON AVE
SAINT LOUIS, MO
63139-2303

Practice Phone: 314-644-3447
Practice Fax:

1346349743 — FARIDA FARZANA
Practice Location Address:

3115 HAMPTON AVE
SAINT LOUIS, MO
63139-2303

Practice Phone: 314-644-3447
Practice Fax:

1871957563 — PAIGE LYNCH LPC
Practice Location Address:

3115 HAMPTON AVE
SAINT LOUIS, MO
63139-2303

Practice Phone: 314-304-1966
Practice Fax:

1588198246 — CHANEY MARIE BELL FNP
Practice Location Address:

1403 HAMPTON AVE
SAINT LOUIS, MO
63139-3115

Practice Phone: 314-955-9355
Practice Fax:

1912659194 — DR. MALLORY BRIANNE STIEREN DC
Practice Location Address:

1403 HAMPTON AVE
SAINT LOUIS, MO
63139-3115

Practice Phone: 314-955-9355
Practice Fax:

Directions to “RENAL TREATMENT CENTERS-ILLINOIS INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.