Advance Child Care LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

036126888 Issued in IL

Legal business name

ADVANCE CHILD CARE LLC

Practice address

2040 W Devon Ave
Chicago, IL 60659-2128

Phone

(773) 984-2939

NPI assigned

Oct 15, 2015

Last updated

Sep 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Naseeruddin Gulam Khan, MD.

Title

Director

Phone

(773) 984-2939

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1306217385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5742 N CHRISTIANA AVE",
            "address_2": "APT 1.S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594594",
            "telephone_number": "773-984-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606592128",
            "telephone_number": "773-984-2939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE CHILD CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-15",
        "last_updated": "2016-09-13",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "NASEERUDDIN",
        "authorized_official_middle_name": "GULAM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-984-2939",
        "authorized_official_credential": "MD."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "036126888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; 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.