Organization
ADVANCED CARDIOVASCULAR CONSULTANTS,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJAY LABROO MD (OWNER)
(309) 788-7522
Entity
Organization
Contact information
Practice address
2200 52ND AVE, MOLINE, IL 61265-6363
(309) 788-7522
(309) 788-7562
Mailing address
2200 52ND AVE, MOLINE, IL 61265-6363
(309) 788-7522
(309) 788-7562
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36084756
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0283911
—
IA
05
—
036084756
—
IL
01
—
047388
HEALTH ALLIANCE
IL
01
—
08132070
BCBC OF IL PROV#
IL
01
—
98576
BCBS OF IA
IA
Enumeration date
01/23/2007
Last updated
01/24/2018
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