Organization Active NPI

Clinical and Interventional Cardiology

  • Specialist
  • Skokie, IL
National Provider Identifier
1699962696
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CLINICAL AND INTERVENTIONAL CARDIOLOGY
Practice address
9669 Kenton Ave
Suite 206
Skokie, IL 60076-1266
Phone
(847) 676-1333
Fax
(847) 676-1727
NPI assigned
Oct 3, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Earl Jose Gilpin, CMA
Title
Certified Medical Assistant
Phone
(847) 676-1333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

9669 Kenton Ave
Suite 206
Skokie, IL 60076-1266

Mailing address

9669 Kenton Ave
Suite 206
Skokie, IL 60076-1266
Phone (847) 676-1333

Other identifiers 1

IdentifierTypeStateIssuer
1635694OtherBCBS

National Provider Directory

National Provider Directory

Locations

9669 Kenton Ave
Ste 103
Skokie, IL 60076
Phone (847) 676-1333

Practitioners & affiliated clinicians

Practitioners 4

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": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1699962696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE",
            "address_2": "SUITE 206",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761266",
            "telephone_number": "847-676-1333",
            "fax_number": "847-676-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE",
            "address_2": "SUITE 206",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761266",
            "telephone_number": "847-676-1333",
            "fax_number": "847-676-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL AND INTERVENTIONAL CARDIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GILPIN",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "CERTIFIED MEDICAL ASSISTANT",
        "authorized_official_telephone_number": "847-676-1333",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CMA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1635694",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.