Organization
CHICAGO HEART AND VASCULAR CONSULTANTS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET GRAHAM-TAYLOR (CHIEF OPERATIONS OFFICER)
(312) 567-2380
Entity
Organization
Contact information
Practice address
2525 S MICHIGAN AVE, 12TH FLOOR, CHICAGO, IL 60616-2333
(312) 567-2380
(312) 328-7739
Mailing address
2525 S MICHIGAN AVE, 12TH FLOOR, CHICAGO, IL 60616-2333
(312) 567-2380
(312) 328-7739
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200870020 A
INDIANA MEDICAID
IN
01
—
21620248
BLUE CROSS/BLUE SHIELD ID
IL
01
—
N301570
WELLCARE PROVIDER
IL
Enumeration date
05/05/2006
Last updated
03/08/2012
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