Provider Demographics
NPI:1235264672
Name:ELGIN CARDIAC SURGERY, S.C.
Entity Type:Organization
Organization Name:ELGIN CARDIAC SURGERY, S.C.
Other - Org Name:NORTHERN ILLINOIS CARDIOTHORACIC AND VASCULAR SURGERY, S.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:STEIMLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-717-3265
Mailing Address - Street 1:1600 N RANDALL RD STE 355
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-7805
Mailing Address - Country:US
Mailing Address - Phone:847-717-3265
Mailing Address - Fax:847-717-3265
Practice Address - Street 1:1600 N RANDALL RD STE 355
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-7805
Practice Address - Country:US
Practice Address - Phone:847-717-3265
Practice Address - Fax:847-717-3265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042.005785208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL668650Medicare ID - Type Unspecified