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General NPI Number Information
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NPI Number | 1811327844
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Entity Type | Organization
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Legal Business Name | METRO HEART & VASCULAR INSTITUTE LTD
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 06/17/2021
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Provider Practice Location Address
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Address Line | 1479 COMMERCE DR
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City | ALGONQUIN
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State | IL
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Zip | 60102-5916
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Country | US
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Telephone | 847-637-5333
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Fax | 866-420-6287
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Provider Business Mailing Address
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Address Line | 1479 COMMERCE DR
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City | ALGONQUIN
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State | IL
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Zip | 60102-5916
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Country | US
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Telephone | 847-637-5333
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Fax | 866-420-6287
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KERI RENWICK
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Credential |
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Telephone | 847-637-5333
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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 | 036128795
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License Number State | IL
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