MEDICARE: CARDIOLOGY CONSULTANTS OF NORTHWESTERN, PC

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
1	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1518932714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOLOGY CONSULTANTS OF NORTHWESTERN, PC

Provider Business Mailing Address
First Line	:	1730 PARK ST
Second Line	:	SUITE 101
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-2688
Country	:	US
Telephone Number	:	630-718-0200
Fax Number	:	630-718-0900

Provider Business Practice Location Address
First Line	:	150 E HURON ST
Second Line	:	SUITE 801
City	:	CHICAGO
State	:	IL
Zip	:	60611-2999
Country	:	US
Telephone Number	:	312-664-3404
Fax Number	:	312-664-9740

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	LYNN YENKO SHELTON-ZOIOPOULOS
Credential	:	D.O.
Telephone Number	:	630-718-0200

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	08/22/2020

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