MEDICARE: ADVANCED THERAPY CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1235162397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED THERAPY CENTER, INC.

Provider Business Mailing Address
First Line	:	2516 WAUKEGAN RD
Second Line	:	SUITE 353
City	:	GLENVIEW
State	:	IL
Zip	:	60025-1774
Country	:	US
Telephone Number	:	847-730-3111
Fax Number	:	847-730-3111

Provider Business Practice Location Address
First Line	:	2516 WAUKEGAN RD
Second Line	:	SUITE 353
City	:	GLENVIEW
State	:	IL
Zip	:	60025-1774
Country	:	US
Telephone Number	:	847-730-3111
Fax Number	:	847-730-3111

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SIMON M. ADANIN
Credential	:
Telephone Number	:	847-730-3111

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	08/22/2020

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