Healthcare Provider Details

I. General information

NPI: 1508810086
Provider Name (Legal Business Name): HEART CARE CENTERS OF ILLINOIS, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13011 S 104TH AVE SUITE 100
PALOS PARK IL
60464-1506
US

IV. Provider business mailing address

13011 S 104TH AVE SUITE 100
PALOS PARK IL
60464-1506
US

V. Phone/Fax

Practice location:
  • Phone: 708-274-3278
  • Fax: 708-274-3299
Mailing address:
  • Phone: 708-478-3600
  • Fax: 708-478-3552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number042007998
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number042007998
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number042007998
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number042007998
License Number StateIL

VIII. Authorized Official

Name: MARK F BERLIN
Title or Position: COO
Credential:
Phone: 708-478-3600