Organization
HEARTCARE MIDWEST , LTD
Active
Other names
OSF Medical Group-HeartCare Midwest
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD FAYAZ MALIK MD (CHIEF MEDIAL OFFICER)
(309) 691-4410
Entity
Organization
Contact information
Practice address
5405 N KNOXVILLE AVENUE, PEORIA, IL 61614-5016
(309) 691-4410
(309) 589-2830
Mailing address
5405 N KNOXVILLE AVENUE, PEORIA, IL 61614-5016
(309) 691-4410
(309) 589-2830
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
363AS0400X
Surgical Physician Assistant
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
364S00000X
Clinical Nurse Specialist
—
—
Other
Enumeration date
06/19/2006
Last updated
12/02/2010
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