Basic Information
| Provider Information | |||||||||
| NPI: | 1255471041 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CARDIAC BILLING SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9410 COMPUBILL DR | ||||||||
| Address2: | |||||||||
| City: | ORLAND PARK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604622627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7084607444 | ||||||||
| FaxNumber: | 7084608662 | ||||||||
| Practice Location | |||||||||
| Address1: | 2701 W 68TH ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606291813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738849000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2007 | ||||||||
| LastUpdateDate: | 05/22/2013 | ||||||||
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| AuthorizedOfficialLastName: | TUMMALA | ||||||||
| AuthorizedOfficialFirstName: | SPRASAD | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7738849000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.