Organization
ADVANCE HEALTH PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA D FAUSTINO APN (PRESIDENT)
(630) 267-2627
Entity
Organization
Contact information
Practice address
2460 HANBURY LN, MONTGOMERY, IL 60538-5049
(630) 708-6941
(630) 344-8100
Mailing address
2460 HANBURY LN, MONTGOMERY, IL 60538-5049
(630) 708-6941
(630) 344-8100
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209.006796
IL
Other
Enumeration date
03/12/2010
Last updated
02/10/2011
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