Organization
ADVANCED NEUROLOGICAL ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY ANGELOPOULOS D.O. (OWNER)
(847) 716-1302
Entity
Organization
Contact information
Practice address
550 W FRONTAGE RD STE 2745, NORTHFIELD, IL 60093-1260
(847) 716-1302
(847) 716-1312
Mailing address
550 W FRONTAGE RD STE 2745, NORTHFIELD, IL 60093-1260
(847) 716-1302
(847) 716-1312
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036-088382
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088382
—
IL
01
—
1630244
BLUE CROSS BLUE SHIELD OF
IL
Enumeration date
07/11/2007
Last updated
12/23/2021
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