Organization
ADVANCED INTEGRATIVE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BLANCHARD (OWNER)
(317) 518-8166
Entity
Organization
Contact information
Practice address
2333 N HARLEM AVE, CHICAGO, IL 60707-2718
(317) 518-8166
Mailing address
202 N SPRUCE DR, MAHOMET, IL 61853-9277
(317) 518-8166
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209012388
IL
Other
Enumeration date
05/06/2016
Last updated
05/25/2016
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