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Organization

LAKE FOREST CARDIOLOGY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KRISHNASWAMI SRIRAM MD (MEMBER)
(847) 615-2273
Entity
Organization

Contact information

Practice address
611 HUNTER LN, LAKE FOREST, IL 60045-4905
(847) 615-2273
Mailing address
611 HUNTER LN, LAKE FOREST, IL 60045-4905
(847) 615-2273

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207RC0000X
Cardiovascular Disease Physician
207RC0001X
Clinical Cardiac Electrophysiology Physician

Other

Enumeration date
11/27/2012
Last updated
04/05/2013
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