Provider Demographics
NPI:1568406882
Name:NORTH SUBURBAN CARDIOLOGY GROUP, LTD
Entity Type:Organization
Organization Name:NORTH SUBURBAN CARDIOLOGY GROUP, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-866-6600
Mailing Address - Street 1:800 AUSTIN ST
Mailing Address - Street 2:WEST TOWER SUITE 408
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3439
Mailing Address - Country:US
Mailing Address - Phone:847-866-6600
Mailing Address - Fax:847-475-6835
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:WEST TOWER SUITE 408
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-866-6600
Practice Address - Fax:847-475-6835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC43299Medicare UPIN
ILC45951Medicare UPIN
C42446Medicare UPIN
ILC43809Medicare UPIN
ILC43297Medicare UPIN