NPIMap

Organization Active NPI

Advanced Family Clinic LTD

  • General Practice Physician
  • Chicago, IL
National Provider Identifier
1093977175
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036119204 Issued in IL
Legal business name
ADVANCED FAMILY CLINIC LTD
Practice address
2246 W Chicago Ave
Chicago, IL 60622-4827
Phone
(773) 276-6831
Fax
(773) 276-9394
NPI assigned
Jun 30, 2008
Last updated
Jun 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Halyna Boryslavska, MD
Title
President
Phone
(773) 276-6831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 036119204 IL Primary

Addresses

Primary practice location

2246 W Chicago Ave
Chicago, IL 60622-4827

Mailing address

2246 W Chicago Ave
Chicago, IL 60622-4827
Phone (773) 276-6831

National Provider Directory

National Provider Directory

Locations

2246 W Chicago Ave
Chicago, IL 60622
Phone (773) 276-6831

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1093977175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2246 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224827",
            "telephone_number": "773-276-6831",
            "fax_number": "773-276-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2246 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224827",
            "telephone_number": "773-276-6831",
            "fax_number": "773-276-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "BORYSLAVSKA",
        "authorized_official_first_name": "HALYNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-276-6831",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "036119204",
            "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 Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.