Provider Demographics
NPI:1376733428
Name:ADVANCED BEHAVIORAL CONCEPTS INC
Entity Type:Organization
Organization Name:ADVANCED BEHAVIORAL CONCEPTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:H
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-829-9148
Mailing Address - Street 1:134 GRAYMOOR LN
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1220
Mailing Address - Country:US
Mailing Address - Phone:708-829-9148
Mailing Address - Fax:708-503-3433
Practice Address - Street 1:2232 E 71ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2522
Practice Address - Country:US
Practice Address - Phone:773-288-0404
Practice Address - Fax:773-288-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211843Medicare Oscar/Certification