Organization Active NPI

Metro Heart & Vascular Institute LTD

  • Cardiovascular Disease Physician
  • Algonquin, IL
National Provider Identifier
1811327844
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036128795 Issued in IL
Legal business name
METRO HEART & VASCULAR INSTITUTE LTD
Practice address
1479 Commerce Dr
Algonquin, IL 60102-5916
Phone
(847) 637-5333
Fax
(866) 420-6287
NPI assigned
Nov 12, 2013
Last updated
Jun 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Authorized official

Name
Keri Renwick
Title
Practice Manager
Phone
(847) 637-5333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 036128795 IL Primary

Addresses

Primary practice location

1479 Commerce Dr
Algonquin, IL 60102-5916

Mailing address

1479 Commerce Dr
Algonquin, IL 60102-5916
Phone (847) 637-5333

Other practice location 1

2410 Alft Ln
Ste. 100
Elgin, IL 60124-7843
Phone (847) 637-5333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131227000317 IL Part B Supplier - Clinic/Group Practice 0446487227 Receives reassigned benefits from 1 practitioner
Practice locations: Algonquin, IL; Barrington, IL; Elgin, IL; Elk Grove Village, IL; Hoffman Estates, IL

National Provider Directory

National Provider Directory

Locations

1345 Ryan Pkwy
Ste 2
Algonquin, IL 60102
Phone (224) 333-0920

Practitioners & affiliated clinicians

Practitioners 1

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": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1811327844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1479 COMMERCE DR",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025916",
            "telephone_number": "847-637-5333",
            "fax_number": "866-420-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 COMMERCE DR",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025916",
            "telephone_number": "847-637-5333",
            "fax_number": "866-420-6287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2410 Alft Ln",
            "address_2": "Ste. 100",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601247843",
            "country_code": "US",
            "telephone_number": "847-637-5333",
            "fax_number": "866-420-6287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "METRO HEART & VASCULAR INSTITUTE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "RENWICK",
        "authorized_official_first_name": "KERI",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "847-637-5333"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036128795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.