Illiana Vascular Centers Inc

Key facts

NPI

1811626344

Entity type

Organization (NPI type 2)

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X

Legal business name

ILLIANA VASCULAR CENTERS INC

Practice address

236 E Irving Park Rd
Wood Dale, IL 60191-2099

Phone

(847) 590-1500

Fax

(847) 590-1502

NPI assigned

Jun 9, 2022

Organization subpart

No

Authorized official

Name

Dominic Tolitano, MD NPI 1811959992

Title

Practice Owner

Phone

(847) 590-1500

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

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

• Dominic J Tolitano, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Wood Dale, IL · NPI 1811959992
  Medicare reassignment NPD Authorized official IN · THORACIC SURGERY (CARDIOTHORACIC VASCULAR SURGERY)
• Amanda Joy Dech, MSN/FNP-C Family Nurse Practitioner · Gary, IN · NPI 1013479260
  Medicare reassignment NPD IN

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IN

Medicare enrollment records

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 9, 2022.

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1811626344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 E IRVING PARK RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912099",
            "telephone_number": "847-590-1500",
            "fax_number": "847-590-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 E IRVING PARK RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601912099",
            "telephone_number": "847-590-1500",
            "fax_number": "847-590-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLIANA VASCULAR CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "TOLITANO",
        "authorized_official_first_name": "DOMINIC",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "847-590-1500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Wood Dale, IL · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Illinois