Organization
INNOVATIVE ADVANCED PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDNESHA RAMEY NP (CO-OWNER/NURSE PRACTITIONER)
(630) 549-5429
Entity
Organization
Contact information
Practice address
4050 HEALTHWAY DR STE 140, AURORA, IL 60504-8184
(630) 549-5429
(773) 912-6727
Mailing address
4050 HEALTHWAY DR STE 140, AURORA, IL 60504-8184
(630) 549-5429
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609354133
—
IL
Enumeration date
08/24/2021
Last updated
05/22/2023
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