Illinois Cardiovascular & Thoracic Surgery, Ltd

LBN: Illinois Cardiovascular & Thoracic Surgery, Ltd
Illinois Cardiovascular & Thoracic Surgery, Ltd is an health care organization with primary practice located at 1505 Eastland Dr Suite 210, Bloomington IL 61701-7906. The organization recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Nuclear Cardiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is the primary health care specialty. Illinois Cardiovascular & Thoracic Surgery, Ltd can be contacted via phone (309) 662-5506, or through Smith, Glen B via phone (309) 662-5506.

Contact Information

Primary practice address
1505 Eastland Dr Suite 210 Bloomington IL 61701-7906
Phone: (309) 662-5506
Fax: (309) 662-5443
Website:
Map and Directions
Authorized official contact:
Name: Smith, Glen B Doctor of Medicine (MD)
Phone: (309) 662-5506

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1962450734
LBN Legal business name Illinois Cardiovascular & Thoracic Surgery, Ltd
DBA Doing business as
Authorized official Smith, Glen B Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2006
Last updated Apr 24th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962450734 NPPES
Illinois Other 05732036 BLUE SHIELD GROUP NUMBER

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