Provider Demographics
NPI:1700242971
Name:ADVANCE SURGICAL INSTRUMENTS INC
Entity Type:Organization
Organization Name:ADVANCE SURGICAL INSTRUMENTS INC
Other - Org Name:ADVANCE HOME MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAWAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-549-9903
Mailing Address - Street 1:402 W BOUGHTON RD STE B
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1800
Mailing Address - Country:US
Mailing Address - Phone:312-549-9903
Mailing Address - Fax:312-549-9904
Practice Address - Street 1:402 W BOUGHTON RD STE B
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1800
Practice Address - Country:US
Practice Address - Phone:312-549-9903
Practice Address - Fax:312-549-9904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies