Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Illinois Cardiovascular & Thoracic Surgery, Ltd

Organization Cardiovascular Disease Physician · NPI 1962450734

Illinois Cardiovascular & Thoracic Surgery, Ltd is a Cardiovascular Disease Physician in Bloomington, Illinois. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
6
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1505 Eastland Dr Ste 210
Bloomington, IL 61701-7906
Phone: (309) 662-5506
Fax: (309) 662-5443
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) Taxonomy 208G00000X
Cardiovascular Disease Physician Taxonomy 207RC0000X
Interventional Cardiology Physician Taxonomy 207RI0011X
Nuclear Cardiology Physician Taxonomy 207UN0901X
Vascular & Interventional Radiology Physician Taxonomy 2085R0204X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1962450734
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Glen Smith — Chiref Operations Officer · (309) 662-5506
NPI enumeratedMay 4, 2006
Last updated in NPPESApril 24, 2012
Mailing address1505 Eastland Dr, Suite 210, Bloomington, IL 61701-7906

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