Provider Demographics
NPI:1407996523
Name:CARDIOVASCULAR & THORACIC SURGERY, P.C.
Entity Type:Organization
Organization Name:CARDIOVASCULAR & THORACIC SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUASHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-920-8501
Mailing Address - Street 1:PO BOX 64568
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85082-4568
Mailing Address - Country:US
Mailing Address - Phone:302-886-2376
Mailing Address - Fax:855-781-4084
Practice Address - Street 1:950 N YORK RD
Practice Address - Street 2:SUITE 104
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2950
Practice Address - Country:US
Practice Address - Phone:630-920-8501
Practice Address - Fax:630-920-8701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02222703OtherBCBS PROVIDER ID
ILDC4878OtherRAILROAD MEDICARE
IL9150272OtherADVOCATE HLTH
IL02222703OtherBCBS PROVIDER ID
ILDC4878OtherRAILROAD MEDICARE
IL=========OtherTIN GROUP PRACTICE
IL210794Medicare PIN