Organization
PROFESSIONAL SERVICES IN CARDIOLOGY PHYSICIANS BILLING GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY CHANOUX (MANAGER)
(773) 975-1600
Entity
Organization
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 975-1600
Mailing address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 975-1600
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA8287
PALMETTO GBA
IL
Enumeration date
08/14/2006
Last updated
08/04/2008
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