Avanti Medical Group of Illinois LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

AVANTI MEDICAL GROUP OF ILLINOIS LLC

Practice address

1485 Palatine Rd
Hoffman Estates, IL 60192-1196

Phone

(318) 465-5874

NPI assigned

Oct 2, 2010

Last updated

Oct 2, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

AVANTI MEDICAL GROUPAs reported in NPPES

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

Authorized official

Name

Amy Graham, RN, BSN

Title

Vice President of Medical Affairs

Phone

(318) 465-5874

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1285977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285977600000",
    "number": "1760791164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 S NAPERVILLE RD",
            "address_2": "SUITE 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601895844",
            "telephone_number": "318-465-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 PALATINE RD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601921196",
            "telephone_number": "318-465-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTI MEDICAL GROUP OF ILLINOIS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVANTI MEDICAL GROUP",
        "enumeration_date": "2010-10-02",
        "last_updated": "2010-10-02",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF MEDICAL AFFAIRS",
        "authorized_official_telephone_number": "318-465-5874",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2010; 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.