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General NPI Number Information
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NPI Number | 1902005010
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Entity Type | Organization
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Legal Business Name | ADVANCED NEUROLOGY, LTD
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 3295 N ARLINGTON HEIGHTS RD STE 102
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City | ARLINGTON HTS
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State | IL
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Zip | 60004-1588
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Country | US
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Telephone | 847-650-9509
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Fax |
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Provider Business Mailing Address
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Address Line | 227 ESTATE CT
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City | NORTHBROOK
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State | IL
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Zip | 60062-1100
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Country | US
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Telephone | 847-650-9509
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GALINA SIMKIN
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Credential | M.D.
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Telephone | 847-650-9509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036094324
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License Number State | IL
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