Provider Demographics
NPI:1912201823
Name:ADVANCED NEUROLOGICAL TESTING SERVICES LLC
Entity Type:Organization
Organization Name:ADVANCED NEUROLOGICAL TESTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SZYMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-322-7117
Mailing Address - Street 1:PO BOX 388775
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-8775
Mailing Address - Country:US
Mailing Address - Phone:888-322-7117
Mailing Address - Fax:888-732-1623
Practice Address - Street 1:5241 S CICERO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-4967
Practice Address - Country:US
Practice Address - Phone:888-322-7117
Practice Address - Fax:888-732-1623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty