Provider Demographics
NPI:1750337077
Name:ADVANCED PHYSICIANS, S.C.
Entity type:Organization
Organization Name:ADVANCED PHYSICIANS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALLANDIGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-789-3338
Mailing Address - Street 1:6300 KINGERY HWY
Mailing Address - Street 2:SUITE 404
Mailing Address - City:WILLOW BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-2248
Mailing Address - Country:US
Mailing Address - Phone:630-789-3338
Mailing Address - Fax:630-789-3394
Practice Address - Street 1:2356 N ELSTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-7110
Practice Address - Country:US
Practice Address - Phone:773-394-1122
Practice Address - Fax:773-394-6513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211949Medicare ID - Type Unspecified