Pediatric Heart Surgery Associates, LLC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

036-099190 Issued in IL

Legal business name

PEDIATRIC HEART SURGERY ASSOCIATES, LLC

Practice address

311 N Walnut Ave
Suite 100
Wood Dale, IL 60191-1566

Phone

(630) 860-0035

Fax

(630) 860-5262

NPI assigned

Feb 12, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Hani A Hennein, MD

Title

President

Phone

(630) 860-0035

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1114166295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6547 N AVONDALE AVE",
            "address_2": "#001",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311573",
            "telephone_number": "773-775-1622",
            "fax_number": "773-775-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N WALNUT AVE",
            "address_2": "SUITE 100",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911566",
            "telephone_number": "630-860-0035",
            "fax_number": "630-860-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEART SURGERY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "HENNEIN",
        "authorized_official_first_name": "HANI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-860-0035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036-099190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Wood Dale, IL
• Providers in Wood Dale, IL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.