NPIMap

Organization Active NPI

Consultants in Cardiovascular Medicine, S. C.

  • Specialist
  • Melrose Park, IL
National Provider Identifier
1164530713
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
36-064782 Issued in IL
Legal business name
CONSULTANTS IN CARDIOVASCULAR MEDICINE, S. C.
Practice address
675 W North Avenue
Suite-210
Melrose Park, IL 60160-1634
Phone
(708) 838-1448
Fax
(708) 344-0508
NPI assigned
Aug 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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

Authorized official

Name
Dr. Jeffrey G. Shanes, M.D.
Title
President
Phone
(708) 838-1448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 36-064782 IL Primary

Addresses

Primary practice location

675 W North Avenue
Suite-210
Melrose Park, IL 60160-1634

Mailing address

675 W North Avenue
Suite-210
Melrose Park, IL 60160-1634
Phone (708) 838-1448

Other identifiers 8

IdentifierTypeStateIssuer
479-70-6233001MedicaidIL
036-064782MedicaidIL
961280OtherILMEDICARE
CC1592OtherILMEDICARE RAILROAD
478-94-8068001MedicaidIL
036-104771MedicaidIL
216577OtherILMEDICARE LOCALITY 015 GROUP PTAN NUMBER
31602469OtherILBCBS

National Provider Directory

National Provider Directory

Locations

130 S Main St
Ste 230
Lombard, IL 60148
Phone (630) 627-3700

675 W North Ave
Ste 207
Melrose Park, IL 60160
Phone (708) 343-8900

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1164530713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVENUE",
            "address_2": "SUITE-210",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-838-1448",
            "fax_number": "708-344-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVENUE",
            "address_2": "SUITE-210",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-838-1448",
            "fax_number": "708-344-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTANTS IN CARDIOVASCULAR MEDICINE, S. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "SHANES",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-838-1448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "36-064782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479-70-6233001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-064782",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "961280",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CC1592",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "478-94-8068001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-104771",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LOCALITY 015 GROUP PTAN NUMBER",
            "identifier": "216577",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31602469",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; 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.