Organization Active NPI

Center for Cardiovascular Excellence SC

  • Interventional Cardiology Physician
  • Crystal Lake, IL
National Provider Identifier
1235408105
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036-084795 Issued in IL
Legal business name
CENTER FOR CARDIOVASCULAR EXCELLENCE SC
Practice address
690 E Terra Cotta Ave Ste a
Crystal Lake, IL 60014-3605
Phone
(815) 455-3800
Fax
(815) 455-3803
NPI assigned
Dec 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Paresh A Rawal, MD
Title
President
Phone
(815) 455-3800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X 036-084795 IL
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X 036-084795 IL Primary

Addresses

Primary practice location

690 E Terra Cotta Ave Ste a
Crystal Lake, IL 60014-3605

Mailing address

690 E Terra Cotta Ave Ste a
Crystal Lake, IL 60014-3605
Phone (815) 455-3800

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3798/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1235408105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 E TERRA COTTA AVE STE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143605",
            "telephone_number": "815-455-3800",
            "fax_number": "815-455-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E TERRA COTTA AVE STE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143605",
            "telephone_number": "815-455-3800",
            "fax_number": "815-455-3803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR CARDIOVASCULAR EXCELLENCE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "RAWAL",
        "authorized_official_first_name": "PARESH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-455-3800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-084795",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036-084795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.