Organization
ASSOCIATED CARDIOVASCULAR PHYSICIANS, S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK PORONSKY (OFFICE MANAGER)
(708) 923-7650
Entity
Organization
Contact information
Practice address
12400 S HARLEM AVE STE 112, PALOS HEIGHTS, IL 60463-1477
(708) 923-7650
(708) 923-7655
Mailing address
12400 S HARLEM AVE STE 112, PALOS HEIGHTS, IL 60463-1477
(708) 923-7650
(708) 923-7655
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207UN0901X
Nuclear Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1617658
BC/BS
IL
Enumeration date
09/27/2006
Last updated
01/04/2019
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