Organization
CARDIOLOGY CONSULTANTS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM BOSWELL (CREDENTIALIST)
(618) 233-6044
Entity
Organization
Contact information
Practice address
340 W LINCOLN ST, BELLEVILLE, IL 62220-1900
(618) 233-6044
(618) 233-3287
Mailing address
340 W LINCOLN ST, BELLEVILLE, IL 62220-1900
(618) 233-6044
(618) 233-3287
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505942706
—
MO
01
—
CB1189
RR MEDICARE
—
01
—
L01129
TRICARE
—
Enumeration date
07/16/2006
Last updated
03/05/2010
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