MEDICARE: RENAL CARE PROVIDERS LLC

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

General Provider Information

NPI Number	:	1669854907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAL CARE PROVIDERS LLC

Provider Business Mailing Address
First Line	:	PO BOX 428
Second Line	:
City	:	LOCKPORT
State	:	IL
Zip	:	60441-6428
Country	:	US
Telephone Number	:	815-741-6830
Fax Number	:	815-741-6832

Provider Business Practice Location Address
First Line	:	10801 S WESTERN AVE STE 101
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-3225
Country	:	US
Telephone Number	:	773-941-8566
Fax Number	:	773-941-6814

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. MORUFU ALAUSA
Credential	:	M.D.
Telephone Number	:	815-741-6830

Provider Enumeration Date	:	06/23/2015
Last Update Date	:	05/05/2026

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