Advanced Medical Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-007731 Issued in IL

Legal business name

ADVANCED MEDICAL CLINIC

Practice address

4009 W Fullerton Ave
Chicago, IL 60639-2103

Phone

(773) 276-3333

Fax

(773) 276-0333

NPI assigned

Oct 10, 2006

Last updated

Mar 24, 2011By 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

Mr. Mohamed M Malas, D.C.NPI 1376657973

Title

Chiropractor

Phone

(773) 276-3333

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Mohamed M Malas, D.C.

  • Chiropractor
  • Chicago, IL
  • NPI 1376657973
  NPD (past) Authorized official

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1386732972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 W. FULLERTON AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392103",
            "telephone_number": "773-276-0222",
            "fax_number": "773-276-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392103",
            "telephone_number": "773-276-3333",
            "fax_number": "773-276-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "MALAS",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "773-276-3333",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-007731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Integrated Medical Therapy Inc.
• Advanced Integrative Medical LLC
• Advanced Long Term Care Aco PLLC
• Advanced Medical Associates, SC
• Advanced Medical Care Chicago LLC
• Advanced Medical Group
• Advanced Medical Supply Inc
• Advanced Medical Team Home Health Care, Inc.
• Advanced Metrorehab Inc.
• Advanced Neuro Pain Clinic Inc

• Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.