Provider Demographics
NPI:1356629604
Name:ADVANCED PREVENTATIVE CARDIOLOGY INC
Entity Type:Organization
Organization Name:ADVANCED PREVENTATIVE CARDIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AGNIESZKA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-654-1281
Mailing Address - Street 1:117 S COOK ST # 180
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-4311
Mailing Address - Country:US
Mailing Address - Phone:847-654-1281
Mailing Address - Fax:847-890-7991
Practice Address - Street 1:650 SPRING HILL RING ROAD
Practice Address - Street 2:STE 2000
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-1297
Practice Address - Country:US
Practice Address - Phone:847-654-1281
Practice Address - Fax:888-396-4184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL6110Medicare PIN
ILIL6111Medicare PIN