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General NPI Number Information
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NPI Number | 1669563789
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Entity Type | Organization
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Legal Business Name | ADVANCE PSYCHIATRY & COUNSELING, SC.
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 1 TIFFANY PT STE 206
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2916
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Country | US
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Telephone | 630-924-1160
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Fax | 630-924-1192
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Provider Business Mailing Address
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Address Line | 1 TIFFANY PT STE 206
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2916
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Country | US
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Telephone | 630-924-1160
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Fax | 630-924-1162
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AQEEL A. KHAN
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Credential | MD
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Telephone | 630-924-1160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036111021
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License Number State | IL
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