Provider Demographics
NPI:1083749378
Name:MIDWEST CHILDREN'S HEART SPECIALISTS, S.C.
Entity Type:Organization
Organization Name:MIDWEST CHILDREN'S HEART SPECIALISTS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOHLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-884-1212
Mailing Address - Street 1:1555 BARRINGTON RD
Mailing Address - Street 2:DOB 1 SUITE 430
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60194-1019
Mailing Address - Country:US
Mailing Address - Phone:847-884-1212
Mailing Address - Fax:847-884-1291
Practice Address - Street 1:1555 BARRINGTON RD
Practice Address - Street 2:DOB 1 SUITE 430
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194-1019
Practice Address - Country:US
Practice Address - Phone:847-884-1212
Practice Address - Fax:847-884-1291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty