Provider Demographics
NPI:1316998578
Name:WEST SUBURBAN CARDIOLOGISTS, LTD.
Entity type:Organization
Organization Name:WEST SUBURBAN CARDIOLOGISTS, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BADDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-880-9722
Mailing Address - Street 1:900 S FRONTAGE RD
Mailing Address - Street 2:SUITE 325
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-4903
Mailing Address - Country:US
Mailing Address - Phone:773-880-9722
Mailing Address - Fax:773-880-9723
Practice Address - Street 1:3118 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3014
Practice Address - Country:US
Practice Address - Phone:773-880-9722
Practice Address - Fax:773-880-9723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060000983207RC0001X, 207RC0000X
IL06000983363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1616378OtherBCBS
IL688350Medicare ID - Type UnspecifiedLOCALITY 16
ILCH4067Medicare ID - Type UnspecifiedRAILROAD LOCALITY 15
IL1616378OtherBCBS
ILCC8542Medicare ID - Type UnspecifiedRAILROAD LOCALITY 16