NPIMap

Organization Active NPI

Cardiovascular Specialists of Illinois LTD

  • Cardiovascular Disease Physician
  • Mount Vernon, IL
National Provider Identifier
1851468979
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIOVASCULAR SPECIALISTS OF ILLINOIS LTD
Practice address
605 N 12TH St
Mount Vernon, IL 62864-2857
Phone
(618) 241-1350
Fax
(618) 241-1353
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Authorized official

Name
Dr. Brian C Jones, MD
Title
President
Phone
(618) 241-1350

Specialties & licenses 1

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

Addresses

Primary practice location

605 N 12TH St
Mount Vernon, IL 62864-2857

Mailing address

605 N 12TH St
Mount Vernon, IL 62864-2857
Phone (618) 241-1350

National Provider Directory

National Provider Directory

Locations

1054 Martin Luther King Dr
Centralia, IL 62801
Phone (618) 244-0031

13 Cusumano Professional PLZ Dr
Mount Vernon, IL 62864
Phone (618) 241-1350

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1851468979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 N 12TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642857",
            "telephone_number": "618-241-1350",
            "fax_number": "618-241-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 N 12TH ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642857",
            "telephone_number": "618-241-1350",
            "fax_number": "618-241-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR SPECIALISTS OF ILLINOIS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-241-1350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.