NPIMap

Organization Active NPI

Advanced Allergy & ENT, LLC

  • Otolaryngology Physician
  • Rockford, IL
National Provider Identifier
1346449022
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ADVANCED ALLERGY & ENT, LLC
Practice address
1235 N Mulford Rd
Suite 100
Rockford, IL 61107-3879
Phone
(815) 484-9900
NPI assigned
Jul 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Andrew I Jun, MD
Title
President/Ceo
Phone
(815) 222-1900

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207KA0200X IL
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X IL Primary
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0007X IL
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207YX0905X IL

Addresses

Primary practice location

1235 N Mulford Rd
Suite 100
Rockford, IL 61107-3879

Mailing address

1235 N Mulford Rd
Suite 100
Rockford, IL 61107-3879
Phone (815) 484-9900

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1346449022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 N MULFORD RD",
            "address_2": "SUITE 100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073879",
            "telephone_number": "815-484-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 N MULFORD RD",
            "address_2": "SUITE 100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073879",
            "telephone_number": "815-484-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ALLERGY & ENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "JUN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "815-222-1900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.