Organization
WICKER PARK HEART SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANILO ANGELES DEANO M.D. (PRESIDENT)
(773) 292-9791
Entity
Organization
Contact information
Practice address
2222 W DIVISION ST, SUITE 300, CHICAGO, IL 60622-2717
(773) 292-9791
(773) 292-9792
Mailing address
2222 W DIVISION ST, SUITE 300, CHICAGO, IL 60622-2717
(773) 292-9791
(773) 292-9792
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1630322
BCBS IL
IL
01
—
CJ3188
RAILROAD MEDICARE
—
Enumeration date
09/16/2006
Last updated
02/07/2012
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