Provider Demographics
NPI:1306031331
Name:HEART CARE USA
Entity Type:Organization
Organization Name:HEART CARE USA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-212-4570
Mailing Address - Street 1:10537 S EWING AVE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-6220
Mailing Address - Country:US
Mailing Address - Phone:312-212-4570
Mailing Address - Fax:773-734-0407
Practice Address - Street 1:10537 S EWING AVE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-6220
Practice Address - Country:US
Practice Address - Phone:312-212-4570
Practice Address - Fax:773-734-0407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory