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General NPI Number Information
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NPI Number | 1689112005
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Entity Type | Organization
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Legal Business Name | CHICAGO VASCULAR INSTITUTE SC
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 02/06/2017
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Provider Practice Location Address
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Address Line | 233 E ERIE ST 204
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City | CHICAGO
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State | IL
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Zip | 60611-2926
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Country | US
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Telephone | 312-423-6662
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Fax |
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Provider Business Mailing Address
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Address Line | 233 E ERIE ST 204
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City | CHICAGO
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State | IL
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Zip | 60611-2926
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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 | OWNER
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Name | KAMBIZ ZORRIASATEYN
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Credential | MD
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Telephone | 404-642-4328
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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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