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General NPI Number Information
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NPI Number | 1821432329
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Entity Type | Organization
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Legal Business Name | LUMEN CARDIOVASCULAR SPECIALISTS,LTD
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 06/07/2013
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Provider Practice Location Address
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Address Line | 183 N ADDISON AVE SUITE 170
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City | ELMHURST
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State | IL
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Zip | 60126-2748
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Country | US
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Telephone | 630-869-0888
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Fax | 630-834-1017
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Provider Business Mailing Address
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Address Line | 183 N ADDISON AVE SUITE 170
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City | ELMHURST
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State | IL
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Zip | 60126-2748
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Country | US
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Telephone | 630-869-0888
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Fax | 630-834-1017
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | ASIF SERAJIAN
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Credential | D.O.
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Telephone | 630-869-0888
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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 | 036126138
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License Number State | IL
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