Premier Cardiac Surgery Center, PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PREMIER CARDIAC SURGERY CENTER, PLLC

Practice address

11560 S. Kedzie Avenue
Suite 102
Merrionette Park, IL 60803

Phone

(708) 972-7520

Fax

(708) 972-7521

NPI assigned

May 17, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Ronald E Stella, MD

Title

Board Chair

Phone

(708) 478-3600

Specialties & licenses 1

Addresses

Other names 1

• Premier Cardiac Surgery Center, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Premier Cardiocascular Surgery CenterCCN 14C0001181

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Heart Care Centers of Illinois, SC

  • Cardiovascular Disease Physician
  • Palos Park, IL
  • NPI 1508810086

  Member Of

  NPD member

Practitioners 1

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

• Kishin Ramani, M.D.

  • Cardiovascular Disease Physician
  • Berwyn, IL
  • NPI 1932163045
  NPD (past)

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1922664622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11560 S. KEDZIE AVENUE",
            "address_2": "SUITE 102",
            "city": "MERRIONETTE PARK",
            "state": "IL",
            "postal_code": "60803",
            "telephone_number": "708-972-7520",
            "fax_number": "708-972-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11560 S. KEDZIE AVENUE",
            "address_2": "SUITE 102",
            "city": "MERRIONETTE PARK",
            "state": "IL",
            "postal_code": "60803",
            "telephone_number": "708-972-7520",
            "fax_number": "708-972-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CARDIAC SURGERY CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-17",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "STELLA",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BOARD CHAIR",
        "authorized_official_telephone_number": "708-478-3600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Cardiac Surgery Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Mahendragouda Patil, M.D.
• Pediatric Communication Specialists, LTD
• Andrew Thomas Peslak
• Rhonda Poole, BA
• Jacqueline Anai Potter, MHP
• Premier Vascular, LLC
• Providers Medical Imaging and Management
• Jalisa Ramirez
• Renal Care Group Chicago Southside, LLC
• Semira Roberts

• Ambulatory Surgical Clinic/Center in Merrionette Park, IL
• Providers in Merrionette Park, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.