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General NPI Number Information
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NPI Number | 1083192215
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Entity Type | Organization
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Legal Business Name | DCC, INC. DBA KIDNEY DIALYSIS AVOIDANCE PROGRAM
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 223 W JACKSON BLVD STE 604
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City | CHICAGO
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State | IL
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Zip | 60606-6956
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Country | US
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Telephone | 623-594-3117
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Fax | 602-714-8853
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Provider Business Mailing Address
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Address Line | 223 W JACKSON BLVD STE 604
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City | CHICAGO
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State | IL
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Zip | 60606-6956
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Country | US
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Telephone | 623-594-3117
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Fax | 602-714-8853
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Authorized Official
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Title or Position | SR DIRECTOR, RISK MGMT & COMPLIANCE
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Name | KEA INGEBORG NIELSEN
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Credential |
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Telephone | 623-594-3117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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