Provider Demographics
NPI:1710575279
Name:CARDIACFIT LLC
Entity Type:Organization
Organization Name:CARDIACFIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:BENDORAITIS
Authorized Official - Suffix:
Authorized Official - Credentials:EXERCISE PHYS
Authorized Official - Phone:773-230-1969
Mailing Address - Street 1:2504 N RICHMOND ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-2620
Mailing Address - Country:US
Mailing Address - Phone:360-798-8738
Mailing Address - Fax:
Practice Address - Street 1:2504 N RICHMOND ST UNIT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2620
Practice Address - Country:US
Practice Address - Phone:360-798-8738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty