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General NPI Number Information
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NPI Number | 1457514960
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Entity Type | Organization
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Legal Business Name | METROPOLITAN CARDIOVASCULAR ASSOCIATES LLC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 10/21/2015
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Provider Practice Location Address
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Address Line | 303 E. ARMY TRAIL RD SUITE 417
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City | BLOOMINGDALE
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State | IL
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Zip | 60108
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Country | US
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Telephone | 708-359-8051
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Fax | 224-653-9645
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Provider Business Mailing Address
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Address Line | 303 E. ARMY TRAIL RD SUITE 417
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City | BLOOMINGDALE
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State | IL
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Zip | 60108
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Country | US
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Telephone | 708-359-8051
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Fax | 224-653-9645
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Authorized Official
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Title or Position | INTERVENTIONAL CARDIOLOGIST
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Name | DR. AZIZ AHMED
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Credential | M.D.
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Telephone | 630-532-8999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036087491
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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 | 036087491
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License Number State | IL
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