Provider Demographics
NPI:1902005010
Name:ADVANCED NEUROLOGY, LTD
Entity Type:Organization
Organization Name:ADVANCED NEUROLOGY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-650-9509
Mailing Address - Street 1:227 ESTATE CT
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1100
Mailing Address - Country:US
Mailing Address - Phone:847-650-9509
Mailing Address - Fax:
Practice Address - Street 1:3295 N ARLINGTON HEIGHTS RD STE 102
Practice Address - Street 2:
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1588
Practice Address - Country:US
Practice Address - Phone:847-650-9509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360943242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094324Medicaid
IL01623065OtherBCBSIL
ILG51338Medicare UPIN
IL036094324Medicaid