Advanced Integrative Medical LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209012388 Issued in IL

Legal business name

ADVANCED INTEGRATIVE MEDICAL LLC

Practice address

2333 N Harlem Ave
Chicago, IL 60707-2718

Phone

(317) 518-8166

NPI assigned

May 6, 2016

Last updated

May 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William Blanchard

Title

Owner

Phone

(317) 518-8166

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1811343072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N SPRUCE DR",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618539277",
            "telephone_number": "317-518-8166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 N HARLEM AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607072718",
            "telephone_number": "317-518-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INTEGRATIVE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "BLANCHARD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-518-8166"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.