Organization
ADVANCED HEALTH INSTITUTE SOUTH LOOP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW WALKER (CEO)
(847) 910-2567
Entity
Organization
Contact information
Practice address
1147 S WABASH AVE STE 250, CHICAGO, IL 60605-2355
(312) 987-4878
(312) 235-0900
Mailing address
1147 S WABASH AVE STE 250, CHICAGO, IL 60605-2355
(312) 987-4878
(312) 235-0909
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038011556
IL
207Q00000X
Family Medicine Physician
Primary
036134095
IL
208100000X
Physical Medicine & Rehabilitation Physician
036112926
IL
208D00000X
General Practice Physician
036060139
IL
363A00000X
Physician Assistant
085003927
IL
363L00000X
Nurse Practitioner
209011079
IL
Other
Enumeration date
01/02/2013
Last updated
04/18/2014
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