Healthcare Provider Details
I. General information
NPI: 1265132914
Provider Name (Legal Business Name): HEART RHYTHM DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2023
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
235 REMINGTON BLVD STE G3
BOLINGBROOK IL
60440-3686
US
IV. Provider business mailing address
PO BOX 713218
CHICAGO IL
60677-1218
US
V. Phone/Fax
- Phone: 217-331-2656
- Fax:
- Phone: 217-331-2656
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATRICK
BAILEY
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 217-331-2656