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Organization

CARDIOTHORACIC & VASCULAR SURGEONS & ASSOC SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN JOSEPH NATALE M.D. (PRESIDENT)
(847) 222-1443
Entity
Organization

Contact information

Practice address
5140 N CALIFORNIA AVE, SUITE 780, CHICAGO, IL 60625-3645
(773) 878-0148
(847) 222-1445
Mailing address
31 LAKE ADALYN DR, S BARRINGTON, IL 60010-9541
(847) 222-1443
(847) 222-1445

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01636263
BLUE CROSS BLUE SHIELD
IL
01
K47100
MEDICARE PTAN
IL
Enumeration date
10/22/2007
Last updated
12/24/2007
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