Provider Demographics
NPI:1528017100
Name:CARDIOLOGY ASSOCIATES OF NORTHERN ILLINOIS
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF NORTHERN ILLINOIS
Other - Org Name:HEARTLAND CARDIOVASCULAR CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:SANKARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-740-1900
Mailing Address - Street 1:301 MADISON ST
Mailing Address - Street 2:SUITE 275
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6549
Mailing Address - Country:US
Mailing Address - Phone:815-740-1900
Mailing Address - Fax:815-725-2413
Practice Address - Street 1:301 MADISON ST
Practice Address - Street 2:STE 207
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6549
Practice Address - Country:US
Practice Address - Phone:815-740-1900
Practice Address - Fax:815-725-2413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL396590Medicare PIN