ADVANCED HEART CARE (NPI# 1356590178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356590178 |
| Entity Type | Organization |
| Organization Name | ADVANCED HEART CARE |
| Practice Address |
4600 Memorial Dr W3 Belleville IL 62226-5366 |
| Mailing Address |
Po Box 23140 Belleville IL 62223-0140 |
| Practice Telephone | 6182228900 |
| Practice Fax Number | 6182228950 |
| Mailing Telephone | 6182228900 |
| Mailing Fax Number | 6182228950 |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2015-01-08 |
| Authorized Official Name | OMAR ALMOUSALLI (OWNER) |
| Authorized Official Telephone | 6182228900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 036097388 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 0360973885 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033281811 | Advanced Heart Care | Internal Medicine | 1414 Stewart Rd, Monroe, MI 48162-9228 | 2006-11-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | ADVANCED HEART CARE, INC. | 3191 Lower Mountain Road, Sanborn, Ny 14132 |
| Street Address |
4600 MEMORIAL DR W3 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245234988 | Ellen Middendorf | Family Medicine | 4600 Memorial Dr, Ste. 160, Belleville, IL 62226-5368 | 2005-06-10 |
| 1922594142 | Keli Nicole Keener | Specialist/Technologist | 4600 Memorial Dr, Belleville, IL 62226-5368 | 2018-07-11 |
| 1952849770 | Kendra Jane Green | Nurse Practitioner | 4600 Memorial Dr, Ste 80, Belleville, IL 62226-5359 | 2017-02-01 |
| 1427504042 | Catherine Bennett | Nurse Practitioner | 4600 Memorial Dr, Suite 200, Belleville, IL 62226-5368 | 2016-09-01 |
| 1558738237 | Christina Moore | Physician Assistant | 4600 Memorial Dr, Suite 200, Belleville, IL 62226-5368 | 2015-08-28 |
| 1588056147 | Miranda Boeckman | Physician Assistant | 4600 Memorial Dr, Belleville, IL 62226-5368 | 2015-02-19 |
| 1033510284 | Msa Alliance, LLC Dba-southern Illinois Vascular and Vein Surgery | Surgery | 4600 Memorial Dr, Suite120, Belleville, IL 62226-5368 | 2014-09-08 |
| 1548680267 | Msa Alliance, LLC | Surgery | 4600 Memorial Dr, Suite W2, Belleville, IL 62226-5368 | 2014-04-21 |
| 1770925760 | Msa Alliance, LLC | Internal Medicine | 4600 Memorial Dr, Suite 200, Belleville, IL 62226-5368 | 2013-07-19 |
| 1982045514 | Ashley A. Wittler | Nurse Practitioner | 4600 Memorial Dr, Ste. 400, Belleville, IL 62226-5368 | 2013-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
| 1760034292 | Optimally Nourished LLC | Clinic/Center | 303 Belmont Ave Ste 2, Belleville, NJ 07109-1103 | 2019-07-15 |
| 1700050242 | Reynolds Chiropractic Center Inc. | Clinic/Center | 9910 Belleville Rd, Belleville, MI 48111 | 2008-04-16 |
| 1629118005 | Belleville Rehabilitation Services,ltd | Clinic/Center | 333 S Illinois St, Suite D, Belleville, IL 62220-2153 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568069805 | Elite Spine & Wellness Center, Inc | Clinic/Center | 5898 Pathfinder Rd, Rockford, IL 61109-4008 | 2020-10-08 |
| 1407453236 | Dirsi, Inc | Clinic/Center | 2112 N Dayton St, Chicago, IL 60614-4302 | 2020-10-05 |
| 1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.