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General NPI Number Information
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NPI Number | 1982436507
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Entity Type | Organization
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Legal Business Name | HEART AND VASCULAR SPECIALISTS LLC
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Dates
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Enumeration Date | 08/14/2024
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 10378 SOUTH . HARLEM AVE CARDIOVASCULAR SUITE
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City | PALOS HILLS
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State | IL
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Zip | 60465
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Country | US
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Telephone | 708-925-7109
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Fax | 708-741-3025
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Provider Business Mailing Address
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Address Line | 2045 W GRAND AVE STE B713681
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City | CHICAGO
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State | IL
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Zip | 60612-1576
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Country | US
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Telephone | 708-529-7109
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Fax | 708-741-3025
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Authorized Official
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Title or Position | PRESIDENT-EMPLOYEE
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Name | TAREK MOHAMAD AHDAB
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Credential | MD
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Telephone | 708-529-7109
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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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Taxonomy #2
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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