NPIMap

Advanced Health Institute South Loop LLC

Organization Active NPI Family Medicine Physician · Chicago, IL

NPI 1619213170 · NPPES record last updated Apr 18, 2014

Key facts

NPI
1619213170
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
036134095 (IL)
Legal business name
ADVANCED HEALTH INSTITUTE SOUTH LOOP LLC
Practice address
1147 S Wabash Ave Ste 250
Chicago, IL 60605-2355
Phone
(312) 987-4878
Fax
(312) 235-0900
NPI assigned
Jan 2, 2013
Organization subpart
No

Authorized official

Name
Matthew Walker
Title
Ceo
Phone
(847) 910-2567

National Provider Directory

Locations

1147 S Wabash Ave
#250
Chicago, IL 60605
Phone (312) 360-1604

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193200000X MULTI-SPECIALTY GROUP		 111N00000X 038011556 IL
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X 036134095 IL Yes
Physical Medicine & Rehabilitation Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208100000X 036112926 IL
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208D00000X 036060139 IL
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP		 363A00000X 085003927 IL
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X 209011079 IL

Addresses

Primary practice location

1147 S Wabash Ave Ste 250
Chicago, IL 60605-2355

Mailing address

1147 S Wabash Ave Ste 250
Chicago, IL 60605-2355
Phone (312) 987-4878

Other providers in Chicago, IL

All providers in Chicago, IL · Family Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.