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General NPI Number Information
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NPI Number | 1215454657
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Entity Type | Organization
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Legal Business Name | EXCEL RENAL CARE SERVICES LLC
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Dates
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Enumeration Date | 08/26/2017
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 3002 N ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60657-3012
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Country | US
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Telephone | 773-296-3003
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Fax | 773-296-3002
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Provider Business Mailing Address
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Address Line | PO BOX 68698
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City | SCHAUMBURG
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State | IL
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Zip | 60168-0698
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Country | US
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Telephone | 281-853-4429
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Fax | 773-296-3002
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Authorized Official
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Title or Position | MANAGER
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Name | KAREEM M SYED SHAH
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Credential |
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Telephone | 630-748-9407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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