Provider Demographics
NPI:1023233731
Name:CARDIOVASCULAR ASSOCIATES OF GLENBROOK AND EVANSTON
Entity type:Organization
Organization Name:CARDIOVASCULAR ASSOCIATES OF GLENBROOK AND EVANSTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SILVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-869-1499
Mailing Address - Street 1:2501 COMPASS ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026
Mailing Address - Country:US
Mailing Address - Phone:847-869-1499
Mailing Address - Fax:847-901-5250
Practice Address - Street 1:2501 COMPASS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8000
Practice Address - Country:US
Practice Address - Phone:847-869-1499
Practice Address - Fax:847-901-5250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632521OtherILLINOIS BLUE SHIELD
IL1720042419OtherNPI OF OTHER LOCATION
IL1720042419OtherNPI OF OTHER LOCATION