Organization
AVANTI MEDICAL GROUP OF ILLINOIS LLC
Active
Parent organization
AVANTI MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVANTI MEDICAL GROUP
Authorized official
AMY GRAHAM RN, BSN (VICE PRESIDENT OF MEDICAL AFFAIRS)
(318) 465-5874
Entity
Organization
Contact information
Practice address
1485 PALATINE RD, HOFFMAN ESTATES, IL 60192-1196
(318) 465-5874
Mailing address
1755 S NAPERVILLE RD, SUITE 100, WHEATON, IL 60189-5844
(318) 465-5874
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/02/2010
Last updated
10/02/2010
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