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General NPI Number Information
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NPI Number | 1538488069
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY GROUP LLC
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Dates
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Enumeration Date | 05/24/2010
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 2850 W 95TH ST SUITE 305
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-2735
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Country | US
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Telephone | 708-425-7272
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Fax | 708-422-6272
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Provider Business Mailing Address
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Address Line | 2850 W 95TH ST SUITE 305
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-2735
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Country | US
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Telephone | 708-425-7272
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Fax | 708-422-6272
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Authorized Official
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Title or Position | PARTNER
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Name | THOMAS J. QUINN
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Credential | MD
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Telephone | 708-425-7272
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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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