Healthcare Provider Details

I. General information

NPI: 1427241934
Provider Name (Legal Business Name): ADVOCATE HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18210 LA GRANGE RD
TINLEY PARK IL
60487-7722
US

IV. Provider business mailing address

205 W TOUHY AVE
PARK RIDGE IL
60068-4256
US

V. Phone/Fax

Practice location:
  • Phone: 708-478-3960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number StateIL

VIII. Authorized Official

Name: MS. SHARON GREC
Title or Position: DIRECTOR
Credential:
Phone: 847-384-3542