Healthcare Provider Details

I. General information

NPI: 1578379707
Provider Name (Legal Business Name): ADVANCED PRACTICE HEALTH INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 DEMPSTER ST STE 106
PARK RIDGE IL
60068-1171
US

IV. Provider business mailing address

1600 DEMPSTER ST STE 106
PARK RIDGE IL
60068-1171
US

V. Phone/Fax

Practice location:
  • Phone: 847-865-4310
  • Fax: 847-865-4031
Mailing address:
  • Phone: 847-865-4310
  • Fax: 847-865-4031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BERNARD ANDRES
Title or Position: OWNER
Credential: APN
Phone: 847-865-4310