SANDRA ILLUM MD PLLC NPI 1144761404

NPI Information

  • NPI: 1144761404
  • Provider Name: SANDRA ILLUM MD PLLC
  • Classification: Internal Medicine - 207RC0000X
  • Specialization: Cardiovascular Disease
  • Entity Type: Organization
  • Doing Business As: ADVANCED HEART AND VASCULAR CENTER
  • Address: 17101 PRESTON RD STE 190S
    DALLAS, TX
    ZIP 75248
  • Phone: (214) 500-1689

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NPI Details

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
1261QM2500XClinic/CenterMedical SpecialtyP1086TEXASNo
2207RC0000XInternal MedicineCardiovascular DiseaseP1086TEXASYes

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
100U3Z7OTHERTEXASBCBS

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: 3/30/2025

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