Provider Demographics
NPI:1891133104
Name:ANNE MARIE KUDELKA, MD, FACC, CENTER FOR HEART HEALTH, LLC
Entity Type:Organization
Organization Name:ANNE MARIE KUDELKA, MD, FACC, CENTER FOR HEART HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUDELKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACC
Authorized Official - Phone:312-787-9332
Mailing Address - Street 1:233 EAST ERIE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-846-6641
Mailing Address - Fax:312-374-1123
Practice Address - Street 1:233 EAST ERIE
Practice Address - Street 2:SUITE 305
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-846-6641
Practice Address - Fax:312-374-1123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-08
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087780261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036087780Medicaid
IL036087780Medicaid