Provider Demographics
NPI:1417150947
Name:ADVOCO MEDICAL INC
Entity Type:Organization
Organization Name:ADVOCO MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LESZKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-341-0182
Mailing Address - Street 1:900 PYOTT RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-8716
Mailing Address - Country:US
Mailing Address - Phone:815-341-0182
Mailing Address - Fax:815-477-1719
Practice Address - Street 1:900 PYOTT RD
Practice Address - Street 2:SUITE 106
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-8716
Practice Address - Country:US
Practice Address - Phone:815-341-0182
Practice Address - Fax:815-477-1719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherEIN