Provider Demographics
NPI:1912192634
Name:OKNER CARDIOLOGY GROUP, LLC
Entity Type:Organization
Organization Name:OKNER CARDIOLOGY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:OKNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-856-0233
Mailing Address - Street 1:1445 N HUNT CLUB RD
Mailing Address - Street 2:101
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-2603
Mailing Address - Country:US
Mailing Address - Phone:847-856-0233
Mailing Address - Fax:847-856-8484
Practice Address - Street 1:1445 N HUNT CLUB RD
Practice Address - Street 2:101
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-2603
Practice Address - Country:US
Practice Address - Phone:847-856-0233
Practice Address - Fax:847-856-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE71198Medicare UPIN