MEDICARE: CHICAGO HEART RHYTHM LLC

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	207RC0001X	Clinical Cardiac Electrophysiology Physician

General Provider Information

NPI Number	:	1811174394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO HEART RHYTHM LLC

Provider Business Mailing Address
First Line	:	PO BOX 257610
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-8633
Country	:	US
Telephone Number	:	773-728-0000
Fax Number	:	773-728-0002

Provider Business Practice Location Address
First Line	:	2222 W DIVISION ST STE 330
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2995
Country	:	US
Telephone Number	:	773-728-0000
Fax Number	:	773-728-0002

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. SAMER DIBS
Credential	:
Telephone Number	:	773-728-0000

Provider Enumeration Date	:	01/27/2008
Last Update Date	:	12/31/2021

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