Advanced Pediatric and Neonatal Medicine, SC

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

036061812 Issued in IL

Legal business name

ADVANCED PEDIATRIC AND NEONATAL MEDICINE, SC

Practice address

473 W Army Trail Rd
Suite 103
Bloomingdale, IL 60108-2674

Phone

(630) 529-6969

Fax

(630) 529-7497

NPI assigned

Feb 23, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Sang J Han, M D

Title

Owner

Phone

(630) 529-6969

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Tax ID family

Advanced Pediatric and Neonatal Medicine SC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Advanced Pediatric and Neonatal Medicine, SC

  • Pediatrics Physician
  • Bloomingdale, IL
  • NPI 1578912457
  NPD tax ID

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266883200000",
    "number": "1093037673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 W ARMY TRAIL RD",
            "address_2": "SUITE 103",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082674",
            "telephone_number": "630-529-6969",
            "fax_number": "630-529-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 W ARMY TRAIL RD",
            "address_2": "SUITE 103",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082674",
            "telephone_number": "630-529-6969",
            "fax_number": "630-529-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PEDIATRIC AND NEONATAL MEDICINE, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-02-23",
        "status": "A",
        "authorized_official_last_name": "HAN",
        "authorized_official_first_name": "SANG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-529-6969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036061812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "208000000X",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061812",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omolola Adeyemi
• Advance Clinical Lab Inc
• Advance Medical LLC
• Advance Psychiatry & Counseling, SC.
• Advanced Clinical Laboratory Inc
• Advanced Pediatric and Neonatal Medicine, SC
• Adventist Glenoaks Hospital (UChicago Medicine AdventHealth Allergy & Asthma at Bloomingdale)
• Adventist Health Partners, Inc (Glenoaks Women's Healthcare)
• Adventist Health Partners, Inc (DuPage Orthopedics)
• Adventist Health Partners, Inc (DuPage Center for Surgery and Breast Health)

• Neonatal-Perinatal Medicine Physician in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Neonatal-Perinatal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.