ADVANCE HEALTH PROVIDERS LLC (NPI# 1063735413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063735413 |
| Entity Type | Organization |
| Organization Name | ADVANCE HEALTH PROVIDERS LLC |
| Practice Address |
2460 Hanbury Ln Montgomery IL 60538-5049 |
| Practice Telephone | 6307086941 |
| Practice Fax Number | 6303448100 |
| Mailing Telephone | 6307086941 |
| Mailing Fax Number | 6303448100 |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2011-02-10 |
| Authorized Official Name | VICTORIA D FAUSTINO (PRESIDENT) |
| Authorized Official Telephone | 6302672627 |
| Authorized Official Credential | APN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209.006796 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2460 HANBURY LN |
| City | MONTGOMERY |
| State | IL |
| Zip Code | 60538-5049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730433384 | Advantage Health Providers, Inc | Nurse Practitioner | 2460 Hanbury Ln, Montgomery, IL 60538-5049 | 2012-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447594296 | Kristina Nancy Hajek | Physician Assistant | 1851 Douglas Road, Montgomery, IL 60538 | 2012-11-17 |
| 1003025248 | Matthew Thomas Neu | Preventive Medicine | 325 Route 31, Caterpillar Inc, Medical Division, Montgomery, IL 60538 | 2007-05-22 |
| 1477761567 | West Suburban Dental Care, Ltd. | Dentist | 1901 Douglas Rd, Montgomery, IL 60538 | 2007-05-20 |
| 1093834079 | David D Leger | Chiropractor | 2100 Baseline Rd, Montgomery, IL 60538 | 2007-03-28 |
| 1790816650 | Tina Elizabeth Sunderland | Specialist/Technologist | 22 Ashlawn Ave, Montgomery, IL 60538 | 2007-03-09 |
| 1720126535 | Nicholas George Tzanetakos | Family Medicine | 99 Boulder Hill Pass, Montgomery, IL 60538 | 2007-02-02 |
| 1184638603 | Neil Stewart Schlupp | Chiropractor | 212 Webster Street, Montgomery, IL 60538 | 2006-07-28 |
| 1275570061 | Ridge Ambulance Service Inc | Ambulance | 1851 Aucutt Rd, Montgomery, IL 60538 | 2006-06-01 |
| 1487855839 | Linda Gioia Arrich | Dentist | 1901 Douglas Rd, Montgomery, IL 60538 | 2007-05-31 |
| 1750508339 | Michael Harry Kontos | Dentist | 20 Boulder Hill Pass, Montgomery, IL 60538 | 2007-04-18 |
| Find all providers in zip 60538 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322271 | Ryan Shannon | Nurse Practitioner | 1722 Pine St Ste 700, Montgomery, AL 36106-1125 | 2020-10-02 |
| 1053805473 | Jolisa Watson | Nurse Practitioner | 1845 Cherry St, Montgomery, AL 36107-2613 | 2018-06-19 |
| 1265976005 | Tracey England | Nurse Practitioner | 2100 Chestnut St, Montgomery, AL 36106-1113 | 2016-12-13 |
| 1841733045 | Angela Floyd | Nurse Practitioner | 1725 Pine St, Montgomery, AL 36106-1109 | 2016-11-21 |
| 1053867945 | Jessica Rollins | Nurse Practitioner | 1845 Cherry St, Montgomery, AL 36107-2613 | 2016-08-30 |
| 1063897635 | Shawona Cannon Daniel | Nurse Practitioner | 2034 Chestnut St, Montgomery, AL 36106-1111 | 2015-07-24 |
| 1861876252 | The Center for Pain of Montgomery PC | Nurse Practitioner | 2065 E South Blvd Ste 401, Montgomery, AL 36116-2462 | 2015-07-15 |
| 1033532874 | Holly Yates Vezertzis | Nurse Practitioner | 2055 E South Blvd, Suite 308, Montgomery, AL 36116-2001 | 2014-01-30 |
| 1861827669 | Lilian Ifeoma Akwuba | Nurse Practitioner | 128 Mitylene Park Ln, Montgomery, AL 36117-3758 | 2013-09-11 |
| 1275875585 | Holly J Cluck | Nurse Practitioner | 2065 E South Blvd, Suite 201, Montgomery, AL 36116-2458 | 2013-03-25 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 60538 |
Please comment or provide details below to improve the information on ADVANCE HEALTH PROVIDERS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.