Organization
SOUTH SUBURBAN CARDIOLOGY LTD
Active
Organization
SOUTH SUBURBAN CARDIOLOGY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMTIAZ HAMID MD (PRESIDENT)
(708) 799-0180
Entity
Organization
Contact information
Practice address
17901 GOVERNORS HWY, SUITE 101, HOMEWOOD, IL 60430-1144
(708) 799-0180
(708) 799-3839
Mailing address
17901 GOVERNORS HWY, SUITE 101, HOMEWOOD, IL 60430-1144
(708) 799-0180
(708) 799-3839
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA0145
RAILROAD MEDICARE
IL
01
—
CB0037
RAILROAD MEDICARE
IL
01
—
CB1134
RR MEDICARE
IL
Enumeration date
11/08/2005
Last updated
04/02/2008
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