Dor Heart & Vascular, PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036101942 Issued in IL

Legal business name

DOR HEART & VASCULAR, PC

Practice address

20 Tower CT
Suite F
Gurnee, IL 60031-5711

Phone

(847) 662-9420

Fax

(847) 662-9457

NPI assigned

Apr 17, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Tracy Freeze

Title

Practice Manager

Phone

(219) 926-8320

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309824000000",
    "number": "1386818557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357",
            "telephone_number": "219-926-8320",
            "fax_number": "219-926-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 TOWER CT",
            "address_2": "SUITE F",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315711",
            "telephone_number": "847-662-9420",
            "fax_number": "847-662-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOR HEART & VASCULAR, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2011-07-05",
        "status": "A",
        "authorized_official_last_name": "FREEZE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "219-926-8320",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036101942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101942",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1982718409",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Leonard Dolan, ATC, PTA
• James William Donald Jr., LCPC
• McKenna Ann Donegon
• Donna Crunkilton-Stiegel LCSW LLC
• Nickole A. Dooley, DO
• Isaac Dor, M.D.
• Virginia Dornik, MT
• Shana Dovel, MOT
• Rebecca Dowling, PT
• Dr. Cooper2 Gentle Dental Assoc., LTD.

• Cardiovascular Disease Physician in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.