Organization
DOR HEART & VASCULAR, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY FREEZE (PRACTICE MANAGER)
(219) 926-8320
Entity
Organization
Contact information
Practice address
20 TOWER CT, SUITE F, GURNEE, IL 60031-5711
(847) 662-9420
(847) 662-9457
Mailing address
PO BOX 2257, CHESTERTON, IN 46304-0357
(219) 926-8320
(219) 926-3524
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036101942
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101942
—
IL
01
—
1982718409
NPI TYPE 1
IL
Enumeration date
04/17/2008
Last updated
07/05/2011
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