Provider Demographics
NPI:1083734453
Name:CARDIAC & VASCULAR SPECIALISTS, S.C.
Entity Type:Organization
Organization Name:CARDIAC & VASCULAR SPECIALISTS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:K
Authorized Official - Last Name:RIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-931-4200
Mailing Address - Street 1:1435 N. RANDALL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-2303
Mailing Address - Country:US
Mailing Address - Phone:847-931-4200
Mailing Address - Fax:847-931-4217
Practice Address - Street 1:1435 N RANDALL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2303
Practice Address - Country:US
Practice Address - Phone:847-931-4200
Practice Address - Fax:847-931-4217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212443Medicare ID - Type UnspecifiedMEDICAR GRP#