Organization Active NPI

Advanced Health Medical LTD

  • General Practice Physician
  • Chicago, IL
National Provider Identifier
1063187631
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ADVANCED HEALTH MEDICAL LTD
Practice address
1147 S Wabash Ave Ste 250B
Chicago, IL 60605-2355
Phone
(312) 987-4878
NPI assigned
Aug 15, 2021
Last updated
Feb 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chanele Smith
Title
Manager
Phone
(239) 260-0530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

1147 S Wabash Ave Ste 250B
Chicago, IL 60605-2355

Mailing address

1147 S Wabash Ave Ste 250B
Chicago, IL 60605-2355
Phone (312) 987-4878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210825002267 IL Part B Supplier - Clinic/Group Practice 5395140610 Receives reassigned benefits from 7 practitioners
Practice locations: Chicago, IL
O20251024002479 IL DME Supplier - Physician - General Practice 5395140610 Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

1147 S Wabash Ave
Chicago, IL 60605
Phone (312) 360-1604

1147 S Wabash Ave
Ste 250B
Chicago, IL 60605
Phone (312) 987-4878

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1063187631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 S WABASH AVE STE 250B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052355",
            "telephone_number": "312-987-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 S WABASH AVE STE 250B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052355",
            "telephone_number": "312-987-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTH MEDICAL LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-15",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHANELE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "239-260-0530"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.