# NORTHERN ILLINOIS CARDIOVASCULAR & THORACIC SPECIALISTS,LLC

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

## Provider details

- **NPI number:** 1700842390
- **Authorized official:** DR. KEITH D BOWERSOX MD,PHD (OWNER/MANAGING PARTNER)
- **Authorized official phone:** (847) 788-1553

## Contact information

- **Practice address:** 880 W CENTRAL RD, SUITE 5300, ARLINGTON HEIGHTS, IL 60005-2355
- **Practice address phone:** (847) 788-1553
- **Practice address fax:** (847) 788-1585
- **Mailing address:** 1100 W CENTRAL RD, SUITE 408, ARLINGTON HEIGHTS, IL 60005-2402
- **Mailing address phone:** (847) 788-1553
- **Mailing address fax:** (847) 788-1585

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/24/2006
- **Last updated:** 08/22/2020