Provider Demographics
NPI:1639232036
Name:CARDIOVASCULAR CONSULTING ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CARDIOVASCULAR CONSULTING ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-942-6166
Mailing Address - Street 1:1400 S LAKE PARK AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6636
Mailing Address - Country:US
Mailing Address - Phone:219-942-6166
Mailing Address - Fax:219-942-4106
Practice Address - Street 1:1400 S LAKE PARK AVE STE 400
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6636
Practice Address - Country:US
Practice Address - Phone:219-942-6166
Practice Address - Fax:219-942-4106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100214720AMedicaid
IN100214720BMedicaid
IN100214720BMedicaid
IN707880Medicare PIN