Organization
ADVANCED ALLERGY & ENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW I JUN MD (PRESIDENT/CEO)
(815) 222-1900
Entity
Organization
Contact information
Practice address
1235 N MULFORD RD, SUITE 100, ROCKFORD, IL 61107-3879
(815) 484-9900
Mailing address
1235 N MULFORD RD, SUITE 100, ROCKFORD, IL 61107-3879
(815) 484-9900
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
IL
207Y00000X
Otolaryngology Physician
Primary
—
IL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
IL
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
IL
Other
Enumeration date
07/13/2007
Last updated
09/28/2007
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