PREVENTIVE CARDIOVASCULAR SERVICES SC (NPI# 1306914791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306914791 |
| Entity Type | Organization |
| Organization Name | PREVENTIVE CARDIOVASCULAR SERVICES SC |
| Practice Address |
356 W Superior St Fl 2 Chicago IL 60654-3416 |
| Mailing Address |
Po Box 187 Tinley Park IL 60477-0187 |
| Practice Telephone | 3129320300 |
| Mailing Telephone | 7084796522 |
| Mailing Fax Number | 7084796597 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2009-09-18 |
| Authorized Official Name | ALAN JACKSON (PRESIDENT) |
| Authorized Official Telephone | 7084796522 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036081595 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036081595 | 05 |
| Street Address |
356 W SUPERIOR ST FL 2 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60654-3416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215169065 | Tamika Burrussi | Specialist | 356 W Superior St Fl 2, Chicago, IL 60654-3416 | 2009-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912523564 | Male-order Men's Health LLC | Pharmacy | 710 N. Dearborn St., Chicago, IL 60654 | 2020-06-19 |
| 1669014924 | Tanner John Magee | Chiropractor | 415 N. Lasalle St., Suite 605, Chicago, IL 60654 | 2019-10-08 |
| 1144873886 | Fraeda Friedman | Social Worker | 451 N Lasalle Dr, Chicago, IL 60654 | 2019-07-22 |
| 1568024040 | Robin Elizabeth Miller | Dietitian, Registered | 770 North Lasalle Street, Suite 800, Chicago, IL 60654 | 2019-07-03 |
| 1487115804 | Ontario Street Operatory Fac | Clinic/Center | 22 W Ontario Street Operatory, Chicago, IL 60654 | 2019-03-28 |
| 1134697683 | Ghazal Kermani | Dentist | 350 North Clark Street, Suite 600, Chicago, IL 60654 | 2018-11-02 |
| 1225516842 | Tyler Jonathan Hinkel | Radiology | 33 W Ontario St Apt 46f, Chicago, IL 60654 | 2018-08-06 |
| 1710495312 | Mia Zarlengo | Dietitian, Registered | 770 N Lasalle Dr, 800, Chicago, IL 60654 | 2018-01-17 |
| 1568970341 | Kelly Lyons | Acupuncturist | 770 N Lasalle St., Suite 800, Chicago, IL 60654 | 2018-01-16 |
| 1407367568 | Amy Mcnicholas | Counselor | 721 N Lasalle, Chicago, IL 60654 | 2017-10-17 |
| Find all providers in zip 60654 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427457399 | Charles Joseph Frahm | Internal Medicine | 1200 E Madison Park, Chicago, IL 60615-2961 | 2014-08-17 |
| 1225447725 | Jeremy R. Estrada | Internal Medicine | 5841 S Maryland Ave # Mc5841, Chicago, IL 60637-1447 | 2014-08-08 |
| 1285049197 | Nidhi Madan | Internal Medicine | 1717 W Congress Pkwy Ste 317, Chicago, IL 60612 | 2014-06-30 |
| 1588097596 | Atif Khawaja Hassan | Internal Medicine | 5140 N California Ave Ste 740, Chicago, IL 60625-7066 | 2013-08-13 |
| 1952651382 | Rajeev Ruben Fernando | Internal Medicine | 365 N Jefferson St, 2712, Chicago, IL 60661-1226 | 2012-09-13 |
| 1174888945 | Mohammad Tarek Kabbany | Internal Medicine | 676 N Saint Clair St Ste 7-730, Chicago, IL 60611-2927 | 2012-07-09 |
| 1740589175 | United Diagnostic Services, LLC | Internal Medicine | 6124 N Milwaukee Ave Ste 2, Chicago, IL 60646-3820 | 2011-03-24 |
| 1932361433 | Sanjay S Gill | Internal Medicine | 2266 N. Lincoln Ave., 3, Chicago, IL 60614 | 2008-06-26 |
| 1053571208 | Curewell Diagnostic Services LLC | Internal Medicine | 6124 N Milwaukee Ave Ste 1, Chicago, IL 60646-3820 | 2008-06-11 |
| 1972760718 | Steve Attanasio | Internal Medicine | 1725 W Harrison St Ste 1159, Chicago, IL 60612 | 2008-05-20 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.