Organization
ILLIANA CARDIOVASCULAR CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAGDISH PATEL MD (PRESIDENT)
(219) 398-9184
Entity
Organization
Contact information
Practice address
2150 GETTLER ST STE 455, DYER, IN 46311
(219) 864-1100
(219) 864-1118
Mailing address
2150 GETTLER ST STE 455, DYER, IN 46311-2381
(219) 864-1100
(219) 864-1118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01029938
IN
207RC0000X
Cardiovascular Disease Physician
036056772
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062002709503950
TRAVELERS RR MEDICARE
—
05
—
100322640
—
IN
Enumeration date
11/01/2006
Last updated
07/18/2018
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