MEDICARE: FRESENIUS MEDICAL CARE CHICAGOLAND, 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
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1356774624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRESENIUS MEDICAL CARE CHICAGOLAND, LLC

Provider Business Mailing Address
First Line	:	6633 S GREEN ST.
Second Line	:	SUITE 100
City	:	CHICAGO
State	:	IL
Zip	:	60621-1943
Country	:	US
Telephone Number	:	773-873-0271
Fax Number	:	773-892-2616

Provider Business Practice Location Address
First Line	:	6633 S GREEN ST.
Second Line	:	SUITE 100
City	:	CHICAGO
State	:	IL
Zip	:	60621-1943
Country	:	US
Telephone Number	:	773-873-0271
Fax Number	:	773-892-2616

Authorized Official
Title or Position	:	SVP AND TREASURER
Name	:	MARK R. FAWCETT
Credential	:
Telephone Number	:	781-699-9000

Provider Enumeration Date	:	08/09/2013
Last Update Date	:	09/24/2020

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