Advanced Internal Medicine, LLC

Organization Active NPI Internal Medicine Physician · Mount Vernon, IL

NPI 1508063405 · NPPES record last updated May 1, 2012

Key facts

NPI
1508063405
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
License
036116700 (IL)
Legal business name
ADVANCED INTERNAL MEDICINE, LLC
Practice address
605 N 12TH St
Hospitalist Office
Mount Vernon, IL 62864-2857
Phone
(618) 241-4016
Fax
(618) 241-3837
NPI assigned
Jul 2, 2007
Organization subpart
No

Authorized official

Name
Dr. Loren Jay Chassels, D.O.
Title
Owner
Phone
(618) 241-4016

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

605 N 12th St
Ofc
Mount Vernon, IL 62864
Phone (618) 241-4016

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X 036116700 IL Yes

Addresses

Primary practice location

605 N 12TH St
Hospitalist Office
Mount Vernon, IL 62864-2857

Mailing address

PO Box 442
Highland, IL 62249-0442
Phone (618) 241-4016

Other providers in Mount Vernon, IL

All providers in Mount Vernon, IL · Internal Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.