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General NPI Number Information
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NPI Number | 1538435656
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Entity Type | Organization
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Legal Business Name | SYMPHONY DIALYSIS LLC
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 03/23/2012
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Provider Practice Location Address
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Address Line | 14255 SOUTH CICERO
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City | CRESTWOOD
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State | IL
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Zip | 60445-2154
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Country | US
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Telephone | 708-824-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 8140 RIVER DR
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City | MORTON GROVE
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State | IL
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Zip | 60053-2637
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Country | US
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Telephone | 847-583-0100
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Fax | 847-583-8873
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Authorized Official
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Title or Position | CFO
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Name | LIZ KOSHY
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Credential |
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Telephone | 847-583-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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