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NPI Code Detail

MEDICARE: FRESENIUS MEDICAL CARE CICERO, LLC

MEDICARE: FRESENIUS MEDICAL CARE CICERO, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/CenterIL

General Provider Information

NPI Number : 1184969628
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRESENIUS MEDICAL CARE CICERO, LLC
Provider Business Mailing Address
First Line : 3000 S CICERO AVE
Second Line :
City : CICERO
State : IL
Zip : 60804-3638
Country : US
Telephone Number : 708-652-7089
Fax Number : 708-652-7259
Provider Business Practice Location Address
First Line : 3000 S CICERO AVE
Second Line :
City : CICERO
State : IL
Zip : 60804-3638
Country : US
Telephone Number : 708-652-7089
Fax Number : 708-652-7259
Authorized Official
Title or Position : VICE PRESIDENT
Name : BARRY L. BLANTON
Credential :
Telephone Number : 781-699-9000
Provider Enumeration Date : 12/11/2012
Last Update Date : 10/18/2023

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Directions to “FRESENIUS MEDICAL CARE CICERO, LLC ” Practice Location

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