| NPI | 1104238534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS GEDZUN Practice Manager 708-478-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology | |
| 207RI0011X Internal Medicine, Interventional Cardiology | |
| 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: IL 207R00000X) | |
| 208600000X Surgery | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2014-05-20 |