NPIMap

Organization Active NPI

Comprehensive Cardiovascular Care, LLC

  • Cardiovascular Disease Physician
  • Gurnee, IL
National Provider Identifier
1093074155
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036101942 Issued in IL
Legal business name
COMPREHENSIVE CARDIOVASCULAR CARE, LLC
Practice address
1790 Nations Dr Ste 111
Gurnee, IL 60031-9175
Phone
(224) 656-5867
Fax
(219) 926-3524
NPI assigned
May 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tracy Freeze
Title
Practice Administrator
Phone
(219) 926-8320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 036101942 IL Primary

Addresses

Primary practice location

1790 Nations Dr Ste 111
Gurnee, IL 60031-9175

Mailing address

PO Box 2257
Chesterton, IN 46304-0357
Phone (219) 926-8320

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1093074155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357",
            "telephone_number": "219-926-8320",
            "fax_number": "219-926-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 NATIONS DR STE 111",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319175",
            "telephone_number": "224-656-5867",
            "fax_number": "219-926-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE CARDIOVASCULAR CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "FREEZE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "219-926-8320"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036101942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.