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HEARTCARE MIDWEST LTD NPI 1720023179


NPI Information

NPI: 1720023179
Provider Name: HEARTCARE MIDWEST , LTD

Doing Business As: OSF MEDICAL GROUP-HEARTCARE MIDWEST

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
5405 N KNOXVILLE AVENUE
PEORIA, IL
ZIP 61614
Phone: (309) 691-4410
Get Directions

HEARTCARE MIDWEST , LTD is a cardiovascular disease internal medicine in Peoria, IL. 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. HEARTCARE MIDWEST , LTD NPI is 1720023179. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Osf Medical Group-heartcare Midwest.

The provider's business location address is:

5405 N KNOXVILLE AVENUE
PEORIA, IL
ZIP 61614-016
Phone: (309) 691-4410
Fax: (309) 589-2830

The provider's authorized official is Muhammad Fayaz Malik .
The authorized official title is Chief Medial Officer and has the following contact phone number (309) 691-4410.

The enumeration date for this NPI number is 6/19/2006 and was last updated on 12/2/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)No
2363AS0400XPhysician AssistantSurgicalNo
3363LA2100XNurse PractitionerAcute CareNo
4363LF0000XNurse PractitionerFamilyNo
5364S00000XClinical Nurse SpecialistNo
6207RC0000XInternal MedicineCardiovascular DiseaseYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1334370MEDICARE ID-TYPE UNSPECIFIEDILLINOISMEDICARE PROVIDER NUMBER

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

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