Healthcare Provider Details

I. General information

NPI: 1467409490
Provider Name (Legal Business Name): ADVANCED PHYSICIANS, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16101 WEBER RD
CREST HILL IL
60435-8742
US

IV. Provider business mailing address

6300 KINGERY HWY SUITE 404
WILLOW BROOK IL
60527-2248
US

V. Phone/Fax

Practice location:
  • Phone: 815-836-3788
  • Fax: 815-836-8784
Mailing address:
  • Phone: 630-789-3338
  • Fax: 630-789-3394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANA M. VALLANDIGHAM
Title or Position: PRESIDENT
Credential: D.C.
Phone: 630-789-3338