Healthcare Provider Details

I. General information

NPI: 1982436507
Provider Name (Legal Business Name): HEART AND VASCULAR SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7350 W COLLEGE DR STE 102
PALOS HEIGHTS IL
60463-1187
US

IV. Provider business mailing address

7350 W COLLEGE DR STE 102
PALOS HEIGHTS IL
60463-1187
US

V. Phone/Fax

Practice location:
  • Phone: 708-367-5158
  • Fax: 708-266-6025
Mailing address:
  • Phone: 708-367-5158
  • Fax: 708-266-6025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: TAREK MOHAMAD AHDAB
Title or Position: PRESIDENT-EMPLOYEE
Credential: MD
Phone: 708-529-7109