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General NPI Number Information
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NPI Number | 1184789968
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Entity Type | Organization
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Legal Business Name | ADVANCED PHYSICIAN'S ASSOCIATION
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2315 E 93RD ST SUITE 440
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City | CHICAGO
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State | IL
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Zip | 60617-3936
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Country | US
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Telephone | 773-374-9292
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Fax | 773-374-4079
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Provider Business Mailing Address
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Address Line | 2315 E 93RD ST SUITE 440
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City | CHICAGO
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State | IL
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Zip | 60617-3936
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Country | US
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Telephone | 773-374-9292
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Fax | 773-374-4079
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Authorized Official
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Title or Position | DIRECTOR - MEDICAL DIRECTOR
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Name | DR. GREGORY E. SMITH
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Credential | MD
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Telephone | 773-374-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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