Provider Demographics
NPI:1972665990
Name:CARDIOVASCULAR CONSULTANTS OF NAPERVILLE, LTD.
Entity Type:Organization
Organization Name:CARDIOVASCULAR CONSULTANTS OF NAPERVILLE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:OSTRENGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-357-4111
Mailing Address - Street 1:100 SPALDING DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6550
Mailing Address - Country:US
Mailing Address - Phone:630-357-4111
Mailing Address - Fax:630-357-4644
Practice Address - Street 1:100 SPALDING DR
Practice Address - Street 2:SUITE 212
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6550
Practice Address - Country:US
Practice Address - Phone:630-357-4111
Practice Address - Fax:630-357-4644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042006369207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036110817Medicaid
IL1801983648OtherNPI-JAMES P. OSTRENGA, MD
IL036057460Medicaid
IL1265525729OtherNPI - MARK R. OTTOLIN,MD
IL2215535OtherBCBSOF IL PROVIDER NUMB
IL036064112Medicaid
IL1588750327OtherNPI-SHARON L. CLINE, M.D.
IL036057460Medicaid
IL036064112Medicaid
IL036110817Medicaid
ILK06833Medicare UPIN