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General NPI Number Information
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NPI Number | 1255447694
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Entity Type | Organization
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Legal Business Name | ADVANCED PHYSICAL MEDICINE ASSOCIATES, S.C.
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5781 NORTH LINCOLN AVENUE
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City | CHICAGO
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State | IL
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Zip | 60659
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Country | US
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Telephone | 630-924-1450
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Fax | 630-924-1459
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Provider Business Mailing Address
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Address Line | 490 WEST LAKE STREET SUITE 105
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City | ROSELLE
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State | IL
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Zip | 60172-3500
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Country | US
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Telephone | 630-924-1450
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Fax | 630-924-1459
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. JOHN C SARANTOPOULOS
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Credential | D.O.
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Telephone | 630-924-1450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | IL
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