SANDRA ILLUM MD PLLC NPI 1144761404

NPI Information

NPI: 1144761404
Provider Name: SANDRA ILLUM MD PLLC

Doing Business As: ADVANCED HEART AND VASCULAR CENTER

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
17101 PRESTON RD STE 190S
DALLAS, TX
ZIP 75248
Phone: (214) 500-1689
Get Directions

SANDRA ILLUM MD PLLC is a cardiovascular disease internal medicine in Dallas, TX. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. SANDRA ILLUM MD PLLC NPI is 1144761404. The provider is registered as an organization entity type.
The provider Is Doing Business As Advanced Heart And Vascular Center.

The provider's business location address is:

17101 PRESTON RD STE 190S
DALLAS, TX
ZIP 75248-331
Phone: (214) 500-1689

The provider's authorized official is Annika Sandra Illum .
The authorized official title is Cardiologist and has the following contact phone number (214) 377-7576.

The enumeration date for this NPI number is 3/20/2017 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM2500X	Clinic/Center	Medical Specialty	P1086	TEXAS	No
2	207RC0000X	Internal Medicine	Cardiovascular Disease	P1086	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00U3Z7	OTHER	TEXAS	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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