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General NPI Number Information
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NPI Number | 1023232857
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY MEDICAL GROUP INC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 6625 S PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60629-5137
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Country | US
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Telephone | 773-585-1555
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Fax | 773-585-1787
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Provider Business Mailing Address
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Address Line | 6625 S PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60629-5137
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Country | US
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Telephone | 773-585-1555
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Fax | 773-585-1787
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. AMER HUSSEINI II
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Credential | M.D. F.A..CC
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Telephone | 773-585-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036062020
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036066157
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License Number State | IL
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