Healthcare Provider Details

I. General information

NPI: 1750570685
Provider Name (Legal Business Name): MIDWEST NEPHROLOGY CONSULTANTS S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 HEALTHWAY DR SUITE# 200
AURORA IL
60504-8183
US

IV. Provider business mailing address

4050 HEALTHWAY DR SUITE# 200
AURORA IL
60504-8183
US

V. Phone/Fax

Practice location:
  • Phone: 630-499-4795
  • Fax:
Mailing address:
  • Phone: 630-499-4795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: HUMA QAMAR - ROHAIL
Title or Position: OWNER
Credential: M.D.
Phone: 630-499-4795