Provider Demographics
NPI:1376536631
Name:CARDIO-RESPIRATORY ASSISTANCE, INC.
Entity Type:Organization
Organization Name:CARDIO-RESPIRATORY ASSISTANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:S
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-784-3877
Mailing Address - Street 1:5915-17 N. LINCOLN AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3728
Mailing Address - Country:US
Mailing Address - Phone:773-784-3877
Mailing Address - Fax:773-784-9852
Practice Address - Street 1:5915-17 N. LINCOLN AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3728
Practice Address - Country:US
Practice Address - Phone:773-784-3877
Practice Address - Fax:773-784-9852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
0237390001Medicare ID - Type Unspecified