# CARDIOSPECIALISTS GROUP LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194844050
- **Authorized official:** DR. BRAD L SUPRENANT D.O. (PRESIDENT)
- **Authorized official phone:** (708) 748-9800

## Contact information

- **Practice address:** 20303 CRAWFORD AVE, SUITE LL3, OLYMPIA FIELDS, IL 60461-1073
- **Practice address phone:** (708) 748-9800
- **Practice address fax:** (708) 748-9807
- **Mailing address:** 20303 CRAWFORD AVE, SUITE LL3, OLYMPIA FIELDS, IL 60461-1073
- **Mailing address phone:** (708) 748-9800
- **Mailing address fax:** (708) 748-9807

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | 036071427 | IL | Yes |

## Other

- **Enumeration date:** 03/29/2007
- **Last updated:** 03/28/2014