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Organization
CHICAGO CARDIO DIAGNOSTICS, L.L.C.
Active
Organization
CHICAGO CARDIO DIAGNOSTICS, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW L DESROSIERS (MEMBER)
(847) 995-8001
Entity
Organization
Contact information
Practice address
270 WILLOBY CT, SCHAUMBURG, IL 60173-2161
(847) 995-8001
(847) 413-0922
Mailing address
PO BOX 59111, SCHAUMBURG, IL 60159-0111
(847) 995-8001
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
5532-4134
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001635632
BC/BS OF IL PROVIDER #
IL
Enumeration date
05/29/2006
Last updated
02/01/2012
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