PROVIDENT DIALYSIS CENTER
NPI 1578170221
Technician, Other - Renal Dialysis in Chicago, IL
NPI Status: Active since September 28, 2020
Contact Information
430 EAST 51ST PL
CHICAGO, IL
ZIP 60615
Phone: (312) 864-0200
- Organization
- Technician, Other
- Renal Dialysis
- CLIA Number: 14D2216191
- CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
- CLIA Exp. Date: 03-09-2027
About PROVIDENT DIALYSIS CENTER
This page provides the complete NPI Profile along with additional information for Provident Dialysis Center, a provider established in Chicago, Illinois operating as a Technician, Other, focusing in renal dialysis . The healthcare provider is registered in the NPI registry with number 1578170221 assigned on September 2020. The practitioner's primary taxonomy code is 2472R0900X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Provident Dialysis Center operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Provident Dialysis Center. The authorized official of this NPI record is Scott Andrle (Director Of Managed Care)
- NPI
- 1578170221
- Provider Legal Name
- COOK COUNTY
- Other Organization Name
- PROVIDENT DIALYSIS CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 430 EAST 51ST PL CHICAGO, IL 60615
- Location Phone
- (312) 864-0200
- Mailing Address
- 430 EAST 51ST PL CHICAGO, IL 60615
- Mailing Phone
- (312) 864-0200
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 09-28-2020
- Last Update Date
- 03-16-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Technician, Other Renal Dialysis
- Taxonomy Code
- 2472R0900X
- Type
- Technologists, Technicians & Other Technical Service Providers
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D2216191
- Facility Type
- End Stage Renal Disease Dialysis Facility
- Certificate Effective Date
- March 10, 2025
- Certificate Expiration Date
- March 09, 2027
- Laboratory Director
- KALYANI PERUMAL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Provident Dialysis Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1578170221, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
CHICAGO, IL 60615
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1578170221, enumerated as an "organization" on September 28, 2020.
The provider is located at 430 EAST 51ST PL CHICAGO, IL 60615 and the phone number is (312) 864-0200.
Technician, Other with taxonomy code 2472R0900X and a focus in Renal Dialysis.
