Basic Information
| Provider Information | |||||||||
| NPI: | 1568600286 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHICAGO CARDIOLOGY INSTITUTE S.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 959061 | ||||||||
| Address2: | |||||||||
| City: | HOFFMAN ESTATES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601959061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2242384160 | ||||||||
| FaxNumber: | 8472149489 | ||||||||
| Practice Location | |||||||||
| Address1: | 804 WOODFIELD RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | SCHAUMBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476059500 | ||||||||
| FaxNumber: | 8476058700 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2009 | ||||||||
| LastUpdateDate: | 04/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | DOSHI | ||||||||
| AuthorizedOfficialFirstName: | PARAG | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8476059500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | 036086709 | IL | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 207UN0901X | 036086709 | IL | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | 207RC0000X | 036086709 | IL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.