Provider Demographics
NPI:1396801536
Name:LINCOLN PARK HEART CENTER, S.C.
Entity type:Organization
Organization Name:LINCOLN PARK HEART CENTER, S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUKHJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-327-8008
Mailing Address - Street 1:62 BAYBROOK LN
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1640
Mailing Address - Country:US
Mailing Address - Phone:773-327-8008
Mailing Address - Fax:773-327-0790
Practice Address - Street 1:2266 N LINCOLN AVE
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3718
Practice Address - Country:US
Practice Address - Phone:773-327-8008
Practice Address - Fax:773-327-0790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-30
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036048281207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036048281Medicaid
IL2201358OtherBCBS
IL2201358OtherBCBS
ILC45069Medicare UPIN