Provider Demographics
NPI:1538681986
Name:USRC HICKORY HILLS. LLC
Entity Type:Organization
Organization Name:USRC HICKORY HILLS. LLC
Other - Org Name:US RENAL CARE HICKORY HILLS DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2700
Mailing Address - Street 1:PO BOX 251549
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-1500
Mailing Address - Country:US
Mailing Address - Phone:214-736-2700
Mailing Address - Fax:
Practice Address - Street 1:9640 S ROBERTS RD STE 3-BA
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-2238
Practice Address - Country:US
Practice Address - Phone:708-459-9598
Practice Address - Fax:708-459-9035
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:US RENAL CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-07
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment