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CONGRESS VASCULAR CENTER LLC NPI 1396267324


NPI Information

NPI: 1396267324
Provider Name: CONGRESS VASCULAR CENTER LLC
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
41 W CONGRESS PKWY FL 1
CHICAGO, IL
ZIP 60605
Phone: (847) 593-8460
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CONGRESS VASCULAR CENTER LLC is a vascular surgery surgery in Chicago, IL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. CONGRESS VASCULAR CENTER LLC NPI is 1396267324. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

41 W CONGRESS PKWY FL 1
CHICAGO, IL
ZIP 60605-531
Phone: (847) 593-8460
Fax: (224) 246-8042

The provider's authorized official is Yan Katsnelson .
The authorized official title is Owner/director and has the following contact phone number (847) 257-1244.

The enumeration date for this NPI number is 7/11/2017 and was last updated on 7/11/2017.


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
12086S0129XSurgeryVascular SurgeryYes

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
1036105104MEDICAIDILLINOIS

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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