Organization
ADVANCED MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT LUSTIG (OWNER)
(561) 654-7814
Entity
Organization
Contact information
Practice address
1624 W DIVISION ST APT 208, CHICAGO, IL 60622-3908
(561) 654-7814
Mailing address
516 N OGDEN AVE # 195, CHICAGO, IL 60642-6421
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
10/02/2025
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