Tallgrass Cardiology Services SC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036051497 Issued in IL

Legal business name

TALLGRASS CARDIOLOGY SERVICES SC

Practice address

475 Brown Blvd
Suite 103
Bourbonnais, IL 60914-2325

Phone

(815) 937-9370

Fax

(815) 937-2700

NPI assigned

Oct 28, 2010

Last updated

Jan 11, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Hershel Liston Wix Jr., M.D.

Title

President

Phone

(815) 937-9370

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1821398439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BROWN BLVD",
            "address_2": "SUITE 103",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142325",
            "telephone_number": "815-937-9370",
            "fax_number": "815-937-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BROWN BLVD",
            "address_2": "SUITE 103",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142325",
            "telephone_number": "815-937-9370",
            "fax_number": "815-937-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLGRASS CARDIOLOGY SERVICES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-28",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "WIX",
        "authorized_official_first_name": "HERSHEL",
        "authorized_official_middle_name": "LISTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-937-9370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036051497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David B Sutherland, M.D.
• Toni Vanessa Sutton, LCPC
• Jerome A Swale, M.D.
• Jennifer Leann Swank
• Afton Kay Swanson, FNP
• Majd Tarabichi, MD
• Philip Taylor
• Teri Boudreau, LTD.
• Shana Marie Teske, NP-C
• The Kindest Nest PLLC

• Cardiovascular Disease Physician in Bourbonnais, IL
• Providers in Bourbonnais, 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 Jan 11, 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.