Healthcare Provider Details

I. General information

NPI: 1720997554
Provider Name (Legal Business Name): PREMIER CARDIOVASCULAR AND VEIN INSTITUTE SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 W BUTTERFIELD RD STE 205
ELMHURST IL
60126-5068
US

IV. Provider business mailing address

1741 W ELLEN ST
CHICAGO IL
60622-3202
US

V. Phone/Fax

Practice location:
  • Phone: 773-612-0059
  • Fax:
Mailing address:
  • Phone: 773-612-0059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SABA KHAN
Title or Position: PRESIDENT
Credential: MD
Phone: 773-612-0059