ILLINOIS CARDIOVASCULAR & THORACIC SURGERY, LTD
NPI 1962450734
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Bloomington, IL

Q: What is Illinois Cardiovascular & Thoracic Surgery, Ltd's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Active since May 04, 2006

1505 EASTLAND DR, SUITE 210, BLOOMINGTON, IL 61701(309) 662-5506(309) 662-5443 Get Directions Write a Review

NPPES record last updated: April 24, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Illinois Cardiovascular & Thoracic Surgery, Ltd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ILLINOIS CARDIOVASCULAR & THORACIC SURGERY, LTD (NPI 1962450734) is a healthcare organization registered as a thoracic surgery (cardiothoracic vascular surgery) in Bloomington, Illinois and active in the NPI registry since May 2006. The organization lists Glen B Smith, Chiref Operations Officer, as its authorized official.

NPPES Registry Identity

NPI1962450734

Entity TypeOrganization

Primary Taxonomy208G00000X

Legal Business NameILLINOIS CARDIOVASCULAR & THORACIC SURGERY, LTD

Location Address1505 EASTLAND DR, SUITE 210Bloomington, IL 61701-7906

Mailing Address1505 Eastland Dr, Suite 210Bloomington, IL 61701-7906 · (309) 662-5506 · Fax (309) 662-5443

Phone(309) 662-5506

Fax(309) 662-5443

Organization SubpartNo

Authorized OfficialGlen B SmithChiref Operations Officer · (309) 662-5506

Enumeration DateMay 4, 2006

Last NPPES UpdateApril 24, 2012

✔ NPI 1962450734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians

Taxonomy Code208G00000X

Definition

A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X

Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X

Also ListedNuclear Medicine · Nuclear CardiologyTaxonomy 207UN0901X

Also ListedRadiology · Vascular & Interventional RadiologyTaxonomy 2085R0204X

Also ListedPhysician AssistantTaxonomy 363A00000X

1505 EASTLAND DR, Bloomington, IL 61701

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Other Identifiers 4

Medicare ID-Type UnspecifiedCK7113Railroad Medicare Group

Medicare ID-Type Unspecified204814IL · Medicare Group Number

Medicare ID-Type Unspecified204815IL · Medicare Group Number

Other05732036IL · Blue Shield Group Number

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. EDWARD LESLIE COLLOTON MD

Ophthalmology

1505 EASTLAND DR, STE 2200
BLOOMINGTON, IL 61701

McLean County (309) 662-7700

DR. CATHARINE JEAN CROCKETT MD

Ophthalmology

1505 EASTLAND DR, STE 2200
BLOOMINGTON, IL 61701

McLean County (309) 662-7700

DR. SCOTT MERRILL PINTER MD

Ophthalmology

1505 EASTLAND DR, STE 2200
BLOOMINGTON, IL 61701

McLean County (309) 662-7700

MR. DANIEL ALBERT NORD MD

Obstetrics & Gynecology

1505 EASTLAND DR, SUITE 230
BLOOMINGTON, IL 61701

McLean County (309) 663-8888

DR. JEFFREY SCOTT POULTER M.D.

Plastic Surgery

1505 EASTLAND DR, STE 350
BLOOMINGTON, IL 61701

McLean County (309) 663-1222

EASTLAND MEDICAL PLAZA SURGICENTER, LLC

Clinic/Center (Ambulatory Surgical)

1505 EASTLAND DR
BLOOMINGTON, IL 61701

McLean County (309) 663-1997

NACHELLE RICHARD CRNA

Nurse Anesthetist, Certified Registered

1505 EASTLAND DR, LL1400
BLOOMINGTON, IL 61701

McLean County (309) 663-4700

DR. TIAN BIN FENG MD

Anesthesiology (Pain Medicine)

1505 EASTLAND DR, LL 1400
BLOOMINGTON, IL 61701

McLean County (309) 663-4700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Illinois Cardiovascular & Thoracic Surgery, Ltd's NPI number?

The NPI number for Illinois Cardiovascular & Thoracic Surgery, Ltd is 1962450734. It was assigned to this organization in the NPPES registry on May 4, 2006.

Where is Illinois Cardiovascular & Thoracic Surgery, Ltd located?

Illinois Cardiovascular & Thoracic Surgery, Ltd is located at 1505 Eastland Dr Suite 210, Bloomington, IL 61701. The listed phone number is (309) 662-5506.

What is Illinois Cardiovascular & Thoracic Surgery, Ltd's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

When was this NPI record last updated?

The NPPES record for Illinois Cardiovascular & Thoracic Surgery, Ltd was last updated on April 24, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.