NPIMap

Organization Active NPI

Advance Psychiatry & Counseling, SC.

  • Psychiatry Physician
  • Bloomingdale, IL
National Provider Identifier
1669563789
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036111021 Issued in IL
Legal business name
ADVANCE PSYCHIATRY & COUNSELING, SC.
Practice address
1 Tiffany PT Ste 206
Bloomingdale, IL 60108-2916
Phone
(630) 924-1160
Fax
(630) 924-1192
NPI assigned
Sep 27, 2006
Last updated
Dec 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Dr. Aqeel A. Khan, MDNPI 1629046735
Title
President
Phone
(630) 924-1160

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036111021 IL Primary

Addresses

Primary practice location

1 Tiffany PT Ste 206
Bloomingdale, IL 60108-2916

Mailing address

1 Tiffany PT Ste 206
Bloomingdale, IL 60108-2916
Phone (630) 924-1160

Other identifiers 3

IdentifierTypeStateIssuer
214675OtherILMEDICARE PROVIDER #
214658OtherILMEDICARE PROVIDER #
214674OtherILMEDICARE PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070213000258 IL Part B Supplier - Clinic/Group Practice 1456353929 Receives reassigned benefits from 17 practitioners

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2024705Advance Psychiatry & Counseling1 Tiffany Pointe, Bloomingdale, IL 60108RegistrationAug 2, 2026

National Provider Directory

National Provider Directory

Locations

1 Tiffany Pt
Ste 206
Bloomingdale, IL 60108
Phone (630) 924-1160

303 E Army Trail Rd
Ste 401
Bloomingdale, IL 60108
Phone (630) 924-1160

Carol Stream, IL 60122

5107 W Jackson Blvd
#21
Chicago, IL 60644
Phone (773) 378-5490

355 Ridge Ave
Evanston, IL 60202
Phone (847) 316-2329

2603 S Washington St
Ste 160
Naperville, IL 60565
Phone (630) 956-4969

928 Joliet St
West Chicago, IL 60185
Phone (630) 231-9292

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1669563789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT STE 206",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082916",
            "telephone_number": "630-924-1160",
            "fax_number": "630-924-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT STE 206",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082916",
            "telephone_number": "630-924-1160",
            "fax_number": "630-924-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE PSYCHIATRY & COUNSELING, SC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AQEEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-924-1160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036111021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER #",
            "identifier": "214675",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER #",
            "identifier": "214658",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER #",
            "identifier": "214674",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.