Organization
MIDWEST CARDIAC CENTER SC
Active
Organization
MIDWEST CARDIAC CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GOPAL LALMALANI MD (DELEGATED OFFIICAL)
(630) 792-0900
Entity
Organization
Contact information
Practice address
6441 S PULASKI RD, CHICAGO, IL 60629-5148
(773) 884-3300
(773) 284-1223
Mailing address
PO BOX 3461, OAK BROOK, IL 60522-3461
(773) 884-3300
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618378
BCBS PROVIDER ID
IL
01
—
CA3244
RAILROAD MEDICARE
IL
01
—
CB1028
RAILROAD MEDICARE
IL
Enumeration date
08/10/2006
Last updated
05/28/2020
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