Advanced Physicians, S.C.
Organization Active NPI Diagnostic Radiology Physician · Crest Hill, IL
NPI 1467409490 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1467409490
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- ADVANCED PHYSICIANS, S.C.
- Practice address
- 16101 Weber Rd
Crest Hill, IL 60435-8742 - Phone
- (815) 836-3788
- Fax
- (815) 836-8784
- NPI assigned
- May 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Dana M. Vallandigham, D.C.
- Title
- President
- Phone
- (630) 789-3338
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 14
-
Sherry Massey, D.C.
-
Dana M. Vallandigham, D.C.
-
Lawrence J. Chan, D.C.
-
Kathryn Marie Ehmann, DPT
-
Syed Fahad, PT
-
Gina A Leno, PT
-
Emily Minerva, FNP
-
Reema C Patel, P.T.
-
David B. Rosania, M.D.
-
Michael Ruiz, P.T.
-
Gregory T Goldstein, M.D.
-
Sasan Payvar, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051111000170 | IL | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 6103879713 | Practice locations: Crest Hill, IL |
National Provider Directory
- Tax ID family
- Advanced Physicians SC
Locations
16101 Weber Rd
Crest Hill, IL 60403
Phone (815) 306-1100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
16101 Weber Rd
Crest Hill, IL 60435-8742
Mailing address
6300 Kingery Hwy
Suite 404
Willow Brook, IL 60527-2248
Phone (630) 789-3338
Other providers in Crest Hill, IL
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- Advanced Physicians, S.C.
- Advanced Therapy & Wellness Center, P.C.
- George Antoine Aghia
- Evaristo Peralta Aguinaldo Jr.
- Azeem Mohsin Ahsan
- Javeed Akhter
All providers in Crest Hill, IL · Diagnostic Radiology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.