Dexter Avancena
Individual provider Active NPI Physical Therapist · Mount Prospect, IL
NPI 1144579822 · NPPES record last updated Sep 10, 2012
Key facts
- NPI
- 1144579822
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070014198 (IL)
- Practice address
- 1020 N Wheeling Rd
Mount Prospect, IL 60056 - Phone
- (847) 977-0623
- NPI assigned
- Sep 10, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070014198 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Afm Associates, S.C. | Past | Accepting new patients | |
| Advanced Physical Medicine & Therapy, LTD. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070014198 | IL | Yes |
Addresses
Primary practice location
1020 N Wheeling Rd
Mount Prospect, IL 60056
Mailing address
1020 N Wheeling Rd
Mount Prospect, IL 60056
Other providers in Mount Prospect, IL
- August J. Durso, Jr. DDS, LTD.
- Philomina Kalathil Augustine
- Authentic Living Therapeutic Services Inc
- Autism Home Support Services
- Sharon Autman
- Warren Y Avny
- Ninos K Awraham
- Ana Ayala
- Parviz Ayrempour
- Shankar Ayyaswamy
All providers in Mount Prospect, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.