Provider Demographics
NPI:1619908969
Name:FOX VALLEY CARDIOVASCULAR CONSULTANTS, LLC
Entity Type:Organization
Organization Name:FOX VALLEY CARDIOVASCULAR CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SANTOSH
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-851-6440
Mailing Address - Street 1:2088 OGDEN AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504
Mailing Address - Country:US
Mailing Address - Phone:630-851-6440
Mailing Address - Fax:630-859-2422
Practice Address - Street 1:2088 OGDEN AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504
Practice Address - Country:US
Practice Address - Phone:630-851-6440
Practice Address - Fax:630-859-2422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCI5836OtherRAILROAD MEDICARE
IL385181Medicare ID - Type Unspecified
ILCI5836Medicare PIN
ILCI5836OtherRAILROAD MEDICARE
IL208277Medicare ID - Type Unspecified
C44747Medicare UPIN