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General NPI Number Information
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NPI Number | 1649542960
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Entity Type | Organization
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Legal Business Name | SATELLITE DIALYSIS OF GLENVIEW LLC
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 12/29/2016
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Provider Practice Location Address
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Address Line | 2601 COMPASS RD SUITE 145
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City | GLENVIEW
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State | IL
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Zip | 60026-8077
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Country | US
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Telephone | 847-832-0001
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Fax | 847-724-4560
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Provider Business Mailing Address
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Address Line | 300 SANTANA ROW SUITE 300
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City | SAN JOSE
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State | CA
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Zip | 95128-2423
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Country | US
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Telephone | 847-832-0001
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Fax | 650-625-6007
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Authorized Official
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Title or Position | SECRETARY/CFO
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Name | SUSAN L DEL BENE
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Credential |
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Telephone | 650-404-3618
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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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