Provider Demographics
NPI:1407588031
Name:ADVANCED ADDICTION CONSULTANTS CO
Entity Type:Organization
Organization Name:ADVANCED ADDICTION CONSULTANTS CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEV-WEISSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-897-9010
Mailing Address - Street 1:541 HELEN DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2527
Mailing Address - Country:US
Mailing Address - Phone:847-897-9010
Mailing Address - Fax:
Practice Address - Street 1:1875 DEMPSTER ST STE 110
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1125
Practice Address - Country:US
Practice Address - Phone:847-897-9010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty