Healthcare Provider Details

I. General information

NPI: 1770933384
Provider Name (Legal Business Name): ADVANCED MEDICAL SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2016
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 N CORPORATE CIR STE D
GRAYSLAKE IL
60030-7813
US

IV. Provider business mailing address

1015 N CORPORATE CIR STE D
GRAYSLAKE IL
60030-7813
US

V. Phone/Fax

Practice location:
  • Phone: 847-599-9900
  • Fax: 847-599-9901
Mailing address:
  • Phone: 847-599-9900
  • Fax: 847-599-9901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JILL E HOWE
Title or Position: EXEC DIR
Credential:
Phone: 847-599-9900