Provider Demographics
NPI:1215268081
Name:GERMANE NEPHROLOGY ASSOCIATES
Entity type:Organization
Organization Name:GERMANE NEPHROLOGY ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MORUFU
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAUSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-941-1800
Mailing Address - Street 1:1544 CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-6862
Mailing Address - Country:US
Mailing Address - Phone:815-941-1800
Mailing Address - Fax:815-941-1806
Practice Address - Street 1:1544 CREEK DR
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-6862
Practice Address - Country:US
Practice Address - Phone:815-941-1800
Practice Address - Fax:815-941-1806
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GERMANE NEPHROLOGY ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036101242174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty