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General NPI Number Information
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NPI Number | 1376733428
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Entity Type | Organization
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Legal Business Name | ADVANCED BEHAVIORAL CONCEPTS INC
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 2232 E 71ST ST
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City | CHICAGO
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State | IL
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Zip | 60649-2522
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Country | US
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Telephone | 773-288-0404
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Fax | 773-288-2444
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Provider Business Mailing Address
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Address Line | 134 GRAYMOOR LN
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1220
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Country | US
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Telephone | 708-829-9148
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Fax | 708-503-3433
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Authorized Official
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Title or Position | CEO
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Name | FRANK H PAIGE
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Credential | M.D.
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Telephone | 708-829-9148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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