Provider Demographics
NPI:1063860807
Name:CARDIOLOGY, ELECTROPHYSIOLOGY AND PACEMAKER SPECIALISTS LTD
Entity Type:Organization
Organization Name:CARDIOLOGY, ELECTROPHYSIOLOGY AND PACEMAKER SPECIALISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:ROSENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:224-585-9200
Mailing Address - Street 1:1875 DEMPSTER ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1186
Mailing Address - Country:US
Mailing Address - Phone:224-585-9200
Mailing Address - Fax:888-818-9182
Practice Address - Street 1:1875 DEMPSTER ST
Practice Address - Street 2:SUITE 150
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1186
Practice Address - Country:US
Practice Address - Phone:224-585-9200
Practice Address - Fax:888-818-9182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty