Provider Demographics
NPI:1548738156
Name:ADVANCED SINUS AND ALLERGY CENTER, S.C
Entity Type:Organization
Organization Name:ADVANCED SINUS AND ALLERGY CENTER, S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-655-7442
Mailing Address - Street 1:1030 HIGGINS RD STE 325
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5740
Mailing Address - Country:US
Mailing Address - Phone:847-655-7442
Mailing Address - Fax:847-655-7450
Practice Address - Street 1:1030 HIGGINS RD STE 325
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5740
Practice Address - Country:US
Practice Address - Phone:847-287-8078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty