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General NPI Number Information
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NPI Number | 1902079718
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Entity Type | Organization
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Legal Business Name | NORTH-WEST CARDIO-VASCULAR CENTER
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Dates
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Enumeration Date | 04/12/2008
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Last Update Date | 11/29/2010
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Provider Practice Location Address
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Address Line | 3115 N HARLEM AVE SUITE 202
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City | CHICAGO
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State | IL
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Zip | 60634-4684
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Country | US
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Telephone | 773-622-5200
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Fax | 773-889-6571
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Provider Business Mailing Address
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Address Line | 3115 N HARLEM AVE SUITE 202
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City | CHICAGO
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State | IL
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Zip | 60634-4684
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Country | US
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Telephone | 773-622-5200
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Fax | 773-889-6571
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Authorized Official
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Title or Position | OWNER
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Name | DR. MIROSLAW T SOCHANSKI
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Credential | M.D.
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Telephone | 773-622-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 0362097687
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License Number State | IL
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