Provident Dialysis Center

LBN: Cook County
Provident Dialysis Center is an health care organization with primary practice located at 430 East 51St Pl , Chicago IL 60615. The organization recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Renal Dialysis, Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment. Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment is the primary health care specialty. Cook County can be contacted via phone (312) 864-0200, or through Andrle, Scott via phone (312) 864-4649.

Contact Information

Primary practice address
430 East 51St Pl Chicago IL 60615
Phone: (312) 864-0200
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Andrle, Scott
Phone: (312) 864-4649

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Renal Dialysis 2472R0900X
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1831846922
LBN Legal business name Cook County
DBA Doing business as Provident Dialysis Center
Authorized official Andrle, Scott
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 8th, 2022
Last updated Mar 16th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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