Provider Demographics
NPI:1528165768
Name:MIDAMERICA CARDIOVASCULAR CONSULTANTS, LTD
Entity type:Organization
Organization Name:MIDAMERICA CARDIOVASCULAR CONSULTANTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGO
Authorized Official - Middle Name:F
Authorized Official - Last Name:CUADROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-636-7575
Mailing Address - Street 1:5009 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2401
Mailing Address - Country:US
Mailing Address - Phone:708-636-7575
Mailing Address - Fax:708-636-7193
Practice Address - Street 1:10837 S CICERO AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-6458
Practice Address - Country:US
Practice Address - Phone:708-636-7575
Practice Address - Fax:708-636-6193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D0961010OtherCLIA #
IL21622931OtherBCBS GROUP PROVIDER #
ILCI8250OtherMEDICARE RR, PALMETTO GBA
IL21622931OtherBCBS GROUP PROVIDER #