# CARDIOTHORACIC ENDOSCOPIC SURGICAL

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

## Provider details

- **NPI number:** 1750673828
- **Authorized official:** MR. ALAN S PANARES CSA (CEO)
- **Authorized official phone:** (312) 593-0824

## Contact information

- **Practice address:** 800 BIESTERFIELD ROAD, ELK GROVE VILLAGE, IL 60007-3397
- **Practice address phone:** (847) 437-5500
- **Mailing address:** 4717 W. PENSACOLA AVE., CHICAGO, IL 60641-1683
- **Mailing address phone:** (312) 593-0824

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | 238.000082 | IL | Yes |

## Other

- **Enumeration date:** 05/09/2011
- **Last updated:** 05/09/2011