Organization
KISHWAUKEE CARDIOLOGY ASSOCIATES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAGDISH R PATEL M.D., FACC (OWNER)
(815) 786-7076
Entity
Organization
Contact information
Practice address
2550 HAUSER ROSS DR STE 100, SYCAMORE, IL 60178-3149
(815) 786-7076
(815) 786-7379
Mailing address
2530 HAUSER ROSS DR, STE 100, SYCAMORE, IL 60178-3162
(815) 748-7076
(815) 748-7070
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01932095
BLUE CROSS BLUE SHIELD- IL
IL
05
—
035090465
—
IL
Enumeration date
09/23/2008
Last updated
03/21/2016
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