Provider Demographics
NPI:1518064724
Name:ADVANCED HEALTH & PHYSICIANS
Entity Type:Organization
Organization Name:ADVANCED HEALTH & PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SUBBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-854-4511
Mailing Address - Street 1:1767 W OGDEN AVE STE 153
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5008
Mailing Address - Country:US
Mailing Address - Phone:630-355-8988
Mailing Address - Fax:630-355-8953
Practice Address - Street 1:1767 W OGDEN AVE STE 153
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5008
Practice Address - Country:US
Practice Address - Phone:630-355-8988
Practice Address - Fax:630-355-8953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X, 111N00000X, 204C00000X, 207R00000X, 225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2223392OtherBC/BS ID NUMBER
ILG76114Medicare UPIN
IL208367Medicare ID - Type UnspecifiedMEDICARE NUMBER
IL2223392OtherBC/BS ID NUMBER
ILK05070Medicare UPIN