Advanced Neurological Associates SC

Key facts

NPI

1003015074

Entity type

Organization (NPI type 2)

Primary specialty

Specialist 174400000X

License

036-088382 (IL)

Legal business name

ADVANCED NEUROLOGICAL ASSOCIATES SC

Practice address

550 W Frontage Rd Ste 2745
Northfield, IL 60093-1260

Phone

(847) 716-1302

Fax

(847) 716-1312

NPI assigned

Jul 11, 2007

Organization subpart

No

Authorized official

Name

Dr. Mary Angelopoulos, D.O. NPI 1417069022

Title

Owner

Phone

(847) 716-1302

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Angelopoulos, D.O. Neurology Physician · Northfield, IL · NPI 1417069022
  Medicare reassignment NPD Authorized official IL

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IL

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 23, 2021.

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1003015074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W FRONTAGE RD STE 2745",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600931260",
            "telephone_number": "847-716-1302",
            "fax_number": "847-716-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W FRONTAGE RD STE 2745",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600931260",
            "telephone_number": "847-716-1302",
            "fax_number": "847-716-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED NEUROLOGICAL ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "ANGELOPOULOS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-716-1302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-088382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088382",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "1630244",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lindsay Adams
• Thomas J Adams, DDS
• Elissah Fay Adkins
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• June E. Aimen, M.S.

All providers in Northfield, IL · Specialist in Illinois