Provider Demographics
NPI:1477520278
Name:ADVANCED CARE & TREATMENT MEDICAL GROUP
Entity Type:Organization
Organization Name:ADVANCED CARE & TREATMENT MEDICAL GROUP
Other - Org Name:ACT MEDICAL GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-986-2286
Mailing Address - Street 1:2473 MCFARLAND RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-6824
Mailing Address - Country:US
Mailing Address - Phone:815-986-2286
Mailing Address - Fax:815-986-2287
Practice Address - Street 1:2473 MCFARLAND RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6824
Practice Address - Country:US
Practice Address - Phone:815-986-2286
Practice Address - Fax:815-986-2287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty