Healthcare Provider Details

I. General information

NPI: 1518064724
Provider Name (Legal Business Name): ADVANCED HEALTH & PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1767 W OGDEN AVE STE 153
NAPERVILLE IL
60540-5008
US

IV. Provider business mailing address

1767 W OGDEN AVE STE 153
NAPERVILLE IL
60540-5008
US

V. Phone/Fax

Practice location:
  • Phone: 630-355-8988
  • Fax: 630-355-8953
Mailing address:
  • Phone: 630-355-8988
  • Fax: 630-355-8953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL
# 6
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. CATHY LYNN SUBBER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 630-854-4511