Healthcare Provider Details

I. General information

NPI: 1063710374
Provider Name (Legal Business Name): ADVANCED PRACTICE CARE CONSULTANTS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 05/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 GREENDALE AVE
PARK RIDGE IL
60068-2053
US

IV. Provider business mailing address

1000 GREENDALE AVE
PARK RIDGE IL
60068-2053
US

V. Phone/Fax

Practice location:
  • Phone: 847-420-5100
  • Fax:
Mailing address:
  • Phone: 847-420-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209005089
License Number StateIL

VIII. Authorized Official

Name: MS. MARIA CATALDO
Title or Position: PRESIDENT
Credential: APN NP
Phone: 847-420-5100