Cordial Medical Center, S.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-107538 Issued in IL

Legal business name

CORDIAL MEDICAL CENTER, S.C.

Practice address

333 E Il Route 83 Ste 105
Mundelein, IL 60060-4278

Phone

(847) 970-9922

Fax

(847) 970-9955

NPI assigned

Apr 25, 2006

Last updated

Aug 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mikhail Khodarkovskiy, M.D.NPI 1215919196

Title

President

Phone

(224) 392-3643

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mikhail Khodarkovskiy, M.D.

  • Family Medicine Physician
  • Mundelein, IL
  • NPI 1215919196
  Medicare reassignment Care Compare group NPD Authorized official
• Bela Glantsman, M.D.

  • Family Medicine Physician
  • Mundelein, IL
  • NPI 1750347803
  Medicare reassignment Care Compare group NPD
• Elena Oreshkina-Moroz, NP

  • Nurse Practitioner
  • Glenview, IL
  • NPI 1548159296
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691884800000",
    "number": "1093771263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E IL ROUTE 83 STE 105",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600604278",
            "telephone_number": "847-970-9922",
            "fax_number": "847-970-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E IL ROUTE 83 STE 105",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600604278",
            "telephone_number": "847-970-9922",
            "fax_number": "847-970-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDIAL MEDICAL CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2023-08-13",
        "certification_date": "2023-08-13",
        "status": "A",
        "authorized_official_last_name": "KHODARKOVSKIY",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-392-3643",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-107538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE NO.",
            "identifier": "036-107538",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION LICENSE NO.",
            "identifier": "042-618285",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony J Collins
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• Odessa P Conorquie, DT
• Thomas Lincoln Conzelman, DC
• Farrah Lemoine Cox, APRN, FNP-BC
• Kristen Lynn Cresswell, O.D.
• James G Cross, DC
• Michael Gregory Crowe
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• Family Medicine Physician in Mundelein, IL
• Providers in Mundelein, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.