Provider Demographics
NPI:1265001010
Name:PRIME CARDIAC ASSOCIATION P C
Entity Type:Organization
Organization Name:PRIME CARDIAC ASSOCIATION P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHITTARANJAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-659-7000
Mailing Address - Street 1:10842 FRANK LN
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-4594
Mailing Address - Country:US
Mailing Address - Phone:219-659-7000
Mailing Address - Fax:
Practice Address - Street 1:12800 S RIDGELAND AVE STE D
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-2391
Practice Address - Country:US
Practice Address - Phone:708-389-7663
Practice Address - Fax:708-389-7664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty