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General NPI Number Information
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NPI Number | 1255453528
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Entity Type | Organization
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Legal Business Name | KIDNEY AND HYPERTENSION CONSULTANTS, S.C.
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 7447 W TALCOTT AVE STE 425
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City | CHICAGO
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State | IL
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Zip | 60631-3704
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Country | US
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Telephone | 773-763-8400
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Fax | 773-774-8085
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Provider Business Mailing Address
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Address Line | 7447 W TALCOTT AVE STE 425
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City | CHICAGO
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State | IL
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Zip | 60631-3704
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Country | US
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Telephone | 773-763-8400
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Fax | 773-774-8085
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Authorized Official
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Title or Position | PHYSICIAN
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Name | LYNN MICHELLE ANDERSON
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Credential |
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Telephone | 773-763-8400
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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 | 042.617788 036.08684
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License Number State | IL
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