Provider Demographics
NPI:1205913308
Name:ADVENT NEUROLOGY SC
Entity type:Organization
Organization Name:ADVENT NEUROLOGY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAILAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARAMREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-640-7377
Mailing Address - Street 1:657 E GOLF RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4968
Mailing Address - Country:US
Mailing Address - Phone:847-640-7377
Mailing Address - Fax:847-640-7977
Practice Address - Street 1:657 E GOLF RD
Practice Address - Street 2:SUITE 304
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4968
Practice Address - Country:US
Practice Address - Phone:847-640-7377
Practice Address - Fax:847-640-7977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDC1155OtherRAIL ROAD MEDICARE
IL01634570OtherBCBS PROVIDER ID
ILDC1155OtherRAIL ROAD MEDICARE
IL01634570OtherBCBS PROVIDER ID