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General NPI Number Information
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NPI Number | 1346169497
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Entity Type | Organization
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Legal Business Name | ADVANCED LONG TERM CARE ACO PLLC
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 3919 W FOSTER AVE
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City | CHICAGO
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State | IL
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Zip | 60625-6056
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Country | US
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Telephone | 941-380-0606
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Fax |
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Provider Business Mailing Address
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Address Line | 401 N MICHIGAN AVE STE 1200
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City | CHICAGO
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State | IL
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Zip | 60611-4264
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHERYL LEE
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Credential |
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Telephone | 941-380-0606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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