NPIMap

Organization Active NPI

Metro Cardiovascular Consultants, LTD

  • Cardiovascular Disease Physician
  • Oak Lawn, IL
National Provider Identifier
1144413766
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
36076049 Issued in IL
Legal business name
METRO CARDIOVASCULAR CONSULTANTS, LTD
Practice address
9115 S Cicero Ave
Oak Lawn, IL 60453-1895
Phone
(708) 229-0300
Fax
(708) 229-0303
NPI assigned
Aug 27, 2007
Last updated
Sep 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Dr. Ali Kutom, MDNPI 1316912918
Title
President
Phone
(708) 229-0300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 36076049 IL Primary

Addresses

Primary practice location

9115 S Cicero Ave
Oak Lawn, IL 60453-1895

Mailing address

9115 S Cicero Ave
Oak Lawn, IL 60453-1895
Phone (708) 229-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060417000236 IL Part B Supplier - Clinic/Group Practice 9032128285 Receives reassigned benefits from 8 practitioners
Practice locations: Oak Lawn, IL

National Provider Directory

National Provider Directory

Locations

9115 S Cicero Ave
Ste 100
Oak Lawn, IL 60453

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1144413766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 S CICERO AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604531895",
            "telephone_number": "708-229-0300",
            "fax_number": "708-229-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9115 S CICERO AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604531895",
            "telephone_number": "708-229-0300",
            "fax_number": "708-229-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO CARDIOVASCULAR CONSULTANTS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "KUTOM",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-229-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "36076049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.