PROVIDENT DIALYSIS CENTER – NPI #1578170221
Technician, Other

PROVIDENT DIALYSIS CENTER is a technician located in CHICAGO, IL. NPPES has assigned the NPI number 1578170221 to PROVIDENT DIALYSIS CENTER on September 28, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PROVIDENT DIALYSIS CENTER” is a dba name, the actual legal business name for this organization is COOK COUNTY. The primary taxonomy selected by this provider is 2472R0900X from the Health Care Provider Taxonomy code set, which is classified as Technician, Other, specializing in Renal Dialysis

The NPI profile was previously updated about 4 years ago on Mar 16, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PROVIDENT DIALYSIS CENTER below.

NPI Profile for
COOK COUNTY

NPI Number
1578170221
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COOK COUNTY
Doing Business As (dba): PROVIDENT DIALYSIS CENTER
Primary location
430 EAST 51ST PL
CHICAGO, IL 60615
Phone: (312) 864-0200 Fax:
Mailing address
Same as primary location
Organization Subpart
Yes - PROVIDENT DIALYSIS CENTER is subpart of another organization.
Authorized Official
SCOTT ANDRLE
DIRECTOR OF MANAGED CARE
Phone: (312) 864-4649
Updated
Certification Date
Mar 16, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2472R0900X
- Technician, Other / Renal Dialysis (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.