Basic Information
| Provider Information | |||||||||
| NPI: | 1174751978 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDRADE | ||||||||
| FirstName: | AMBAR | ||||||||
| MiddleName: | AFSHAR | ||||||||
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| Credential: | M.D., FACC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4440 W. 95 ST., OPP 6409P | ||||||||
| Address2: | ADVOCATE CHRIST MEDICAL CENTER HEART INSTITUTE | ||||||||
| City: | OAK LAWN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604532600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086847031 | ||||||||
| FaxNumber: | 7085201875 | ||||||||
| Practice Location | |||||||||
| Address1: | 4440 W. 95TH ST, HEART INSTITUTE OPP | ||||||||
| Address2: | ADVOCATE CHRIST MEDICAL CENTER | ||||||||
| City: | OAK LAWN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604532600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7086847031 | ||||||||
| FaxNumber: | 7085201875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2009 | ||||||||
| LastUpdateDate: | 05/13/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036-137440 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 036-137440 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RA0001X | 036-137440 | IL | Y |
No ID Information.