Provider Demographics
NPI:1013212190
Name:HEALTHY HEARTS DOCTORS LLC
Entity Type:Organization
Organization Name:HEALTHY HEARTS DOCTORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUHANNAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-847-9795
Mailing Address - Street 1:1318 W PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:COUNTRYSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-3456
Mailing Address - Country:US
Mailing Address - Phone:630-847-9795
Mailing Address - Fax:630-780-2991
Practice Address - Street 1:6920 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3685
Practice Address - Country:US
Practice Address - Phone:630-847-9795
Practice Address - Fax:630-780-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty