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General NPI Number Information
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NPI Number | 1275651317
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Entity Type | Organization
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Legal Business Name | ST JOHN HEART CLINIC SC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 820 N ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60622-5101
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Country | US
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Telephone | 312-733-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 218 INDIAN TRAIL RD
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City | OAK BROOK
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State | IL
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Zip | 60523-2796
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN PASCUAL MONTEVERDE
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Credential | M.D.
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Telephone | 312-733-4000
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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 |
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License Number State |
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