Organization
DOMINIC J TOLITANO, MD SC
Active
Other names
Suburban Cardiovascular Surgery Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIC J TOLITANO MD (PRESIDENT)
(630) 860-0035
Entity
Organization
Contact information
Practice address
311 N. WALNUT AVE, SUITE 100, WOOD DALE, IL 60191
(630) 860-0035
(630) 860-5262
Mailing address
PO BOX 126, WOOD DALE, IL 60191
(630) 860-0035
(630) 860-5262
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
042617537
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02233112
BCBS PROVIDER ID
IL
01
—
042617537
REGISTERED CORP LICENSE
IL
01
—
780000579
RAILROAD MEDICARE
IL
01
—
DG8754
RAIL ROAD MEDICARE
IL
Enumeration date
10/12/2006
Last updated
03/04/2010
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