Provider Demographics
NPI:1316059942
Name:CARDIOSPECIALISTS GROUP LTD
Entity type:Organization
Organization Name:CARDIOSPECIALISTS GROUP LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:U
Authorized Official - Last Name:HASPEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:708-748-9800
Mailing Address - Street 1:PO BOX 97680
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60678-7680
Mailing Address - Country:US
Mailing Address - Phone:708-748-9800
Mailing Address - Fax:708-748-9807
Practice Address - Street 1:375 N WALL ST
Practice Address - Street 2:SUITE 420
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3483
Practice Address - Country:US
Practice Address - Phone:815-939-9400
Practice Address - Fax:815-939-9494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21608902OtherBC BS OF IL
IL204424Medicare PIN