Provider Demographics
NPI:1295906147
Name:HEART CARE CENTERS OF SOUTH CHICAGO, LTD
Entity type:Organization
Organization Name:HEART CARE CENTERS OF SOUTH CHICAGO, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIRENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BISLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-933-0700
Mailing Address - Street 1:833 W LINCOLN HWY
Mailing Address - Street 2:SUITE 200W
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-1638
Mailing Address - Country:US
Mailing Address - Phone:219-934-5300
Mailing Address - Fax:219-934-5389
Practice Address - Street 1:9011 S COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-4304
Practice Address - Country:US
Practice Address - Phone:773-933-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01639084OtherBCBS
IN200906430Medicaid
IL216739Medicare PIN