Organization
SANDRA ILLUM MD PLLC
Active
Other names
Advanced Heart and Vascular Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNIKA SANDRA ILLUM MD (CARDIOLOGIST)
(214) 377-7576
Entity
Organization
Contact information
Practice address
17101 PRESTON RD STE 190S, DALLAS, TX 75248-1331
(214) 500-1689
Mailing address
17101 PRESTON RD, DALLAS, TX 75248-1331
(214) 377-7576
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
P1086
TX
261QM2500X
Medical Specialty Clinic/Center
P1086
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U3Z7
BCBS
TX
Enumeration date
03/20/2017
Last updated
07/21/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up