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General NPI Number Information
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NPI Number | 1023116233
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Entity Type | Organization
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Legal Business Name | UNIVERSITY THORACIC SURGEONS
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 02/25/2011
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST SUITE 774
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City | CHICAGO
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State | IL
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Zip | 60612
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Country | US
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Telephone | 312-942-6725
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Fax | 312-942-6730
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Provider Business Mailing Address
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Address Line | 1725 W HARRISON ST SUITE 774
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City | CHICAGO
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State | IL
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Zip | 60612
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Country | US
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Telephone | 312-942-6725
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Fax | 312-942-6730
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/ADMINISTRATOR
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Name | JANICE BURKART
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Credential |
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Telephone | 312-563-4334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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