Provider Demographics
NPI:1457514960
Name:METROPOLITAN CARDIOVASCULAR ASSOCIATES LLC
Entity Type:Organization
Organization Name:METROPOLITAN CARDIOVASCULAR ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERVENTIONAL CARDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AZIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-532-8999
Mailing Address - Street 1:303 E. ARMY TRAIL RD
Mailing Address - Street 2:SUITE 417
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108
Mailing Address - Country:US
Mailing Address - Phone:708-359-8051
Mailing Address - Fax:224-653-9645
Practice Address - Street 1:303 E. ARMY TRAIL RD
Practice Address - Street 2:SUITE 417
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108
Practice Address - Country:US
Practice Address - Phone:708-359-8051
Practice Address - Fax:224-653-9645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087491174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036087491Medicaid
IL036087491Medicaid
ILL82630Medicare UPIN