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NPI Code Detail

MEDICARE: CENTER FOR CARDIOVASCULAR EXCELLENCE SC

MEDICARE: CENTER FOR CARDIOVASCULAR EXCELLENCE SC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician036-084795IL
2207RI0011XInterventional Cardiology Physician036-084795IL

General Provider Information

NPI Number : 1235408105
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER FOR CARDIOVASCULAR EXCELLENCE SC
Provider Business Mailing Address
First Line : 690 E TERRA COTTA AVE STE A
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-3605
Country : US
Telephone Number : 815-455-3800
Fax Number : 815-455-3803
Provider Business Practice Location Address
First Line : 690 E TERRA COTTA AVE STE A
Second Line :
City : CRYSTAL LAKE
State : IL
Zip : 60014-3605
Country : US
Telephone Number : 815-455-3800
Fax Number : 815-455-3803
Authorized Official
Title or Position : PRESIDENT
Name : PARESH A RAWAL
Credential : MD
Telephone Number : 815-455-3800
Provider Enumeration Date : 12/22/2011
Last Update Date : 09/16/2019

Similar Medicare Providers

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Practice Location Address:
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1316192974 — NITIN KHER MD SC
Practice Location Address:
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Practice Phone: 815-307-8075
Practice Fax: 815-344-4302

Directions to “CENTER FOR CARDIOVASCULAR EXCELLENCE SC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.