Organization
ADVANCE CHILD CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NASEERUDDIN GULAM KHAN MD. (DIRECTOR)
(773) 984-2939
Entity
Organization
Contact information
Practice address
2040 W DEVON AVE, CHICAGO, IL 60659-2128
(773) 984-2939
Mailing address
5742 N CHRISTIANA AVE, APT 1.S, CHICAGO, IL 60659-4594
(773) 984-2939
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036126888
IL
Other
Enumeration date
10/15/2015
Last updated
09/13/2016
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