Provider Demographics
NPI:1164754644
Name:ADVANCED HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:ADVANCED HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:MOUTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-364-0261
Mailing Address - Street 1:10646 165TH ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-8734
Mailing Address - Country:US
Mailing Address - Phone:708-364-0261
Mailing Address - Fax:708-364-9607
Practice Address - Street 1:2501 COMPASS RD STE 105
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8000
Practice Address - Country:US
Practice Address - Phone:847-768-9915
Practice Address - Fax:708-364-9607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies