Provider Demographics
NPI:1356449383
Name:ADVOCATE MEDICAL GROUP
Entity Type:Organization
Organization Name:ADVOCATE MEDICAL GROUP
Other - Org Name:ILLINOIS PROFESSIONALS HEALTH PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR CASE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, CSADC
Authorized Official - Phone:847-795-2842
Mailing Address - Street 1:701 LEE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4539
Mailing Address - Country:US
Mailing Address - Phone:847-795-2842
Mailing Address - Fax:847-795-2847
Practice Address - Street 1:701 LEE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4539
Practice Address - Country:US
Practice Address - Phone:847-795-2842
Practice Address - Fax:847-795-2847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1916101YA0400X
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty