Provider Demographics
NPI:1205846052
Name:HEART HORIZONS LLC DBA RUSH COPLEY CARDIAC DIAGNOSTIC CENTER
Entity Type:Organization
Organization Name:HEART HORIZONS LLC DBA RUSH COPLEY CARDIAC DIAGNOSTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-723-3380
Mailing Address - Street 1:2088 OGDEN AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4376
Mailing Address - Country:US
Mailing Address - Phone:630-978-4830
Mailing Address - Fax:630-978-6815
Practice Address - Street 1:2088 OGDEN AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4376
Practice Address - Country:US
Practice Address - Phone:630-978-4830
Practice Address - Fax:630-978-6815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2232338OtherBCBS NUMBER
IL2232338OtherBCBS NUMBER