Provider Demographics
NPI:1124075288
Name:ADVANCED PHYSICIANS, S.C.
Entity type:Organization
Organization Name:ADVANCED PHYSICIANS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALLANDIGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-306-1100
Mailing Address - Street 1:16101 WEBER RD
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-8812
Mailing Address - Country:US
Mailing Address - Phone:815-836-3799
Mailing Address - Fax:815-836-8799
Practice Address - Street 1:16101 WEBER RD
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-8812
Practice Address - Country:US
Practice Address - Phone:815-836-3799
Practice Address - Fax:815-836-8799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211051Medicare ID - Type Unspecified