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Organization

CONSULTANTS IN CARDIOVASCULAR MEDICINE, S. C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY G. SHANES M.D. (PRESIDENT)
(708) 838-1448
Entity
Organization

Contact information

Practice address
675 W NORTH AVENUE, SUITE-210, MELROSE PARK, IL 60160-1634
(708) 838-1448
(708) 344-0508
Mailing address
675 W NORTH AVENUE, SUITE-210, MELROSE PARK, IL 60160-1634
(708) 838-1448
(708) 344-0508

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36-064782
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036-064782
IL
05
036-104771
IL
01
216577
MEDICARE LOCALITY 015 GROUP PTAN NUMBER
IL
01
31602469
BCBS
IL
05
478-94-8068001
IL
05
479-70-6233001
IL
01
961280
MEDICARE
IL
01
CC1592
MEDICARE RAILROAD
IL
Enumeration date
08/25/2006
Last updated
07/09/2014
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