Provider Demographics
NPI:1134241383
Name:EP CONSULTATION, LTD
Entity type:Organization
Organization Name:EP CONSULTATION, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:OVADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-612-4184
Mailing Address - Street 1:1875 DEMPSTER STREET
Mailing Address - Street 2:SUITE 605
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:847-823-0843
Mailing Address - Fax:847-692-6755
Practice Address - Street 1:MARC OVADIA M.D. ASCENSION ST. ALEXIUS HOSPITAL
Practice Address - Street 2:1555 NORTH BARRINGTON ROAD/ DOCTORS' BUILDING 3
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169
Practice Address - Country:US
Practice Address - Phone:773-612-4184
Practice Address - Fax:847-692-6755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361030802080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
210809Medicare ID - Type Unspecified