Provider Demographics
NPI:1215596598
Name:CONCERTO KANSAS LLC
Entity Type:Organization
Organization Name:CONCERTO KANSAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYSTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-233-1202
Mailing Address - Street 1:4600 W TOUHY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1606
Mailing Address - Country:US
Mailing Address - Phone:847-443-1228
Mailing Address - Fax:847-443-1328
Practice Address - Street 1:6740 W 121ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2002
Practice Address - Country:US
Practice Address - Phone:847-443-1228
Practice Address - Fax:847-443-1328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment