Provider Demographics
NPI:1366408387
Name:ADVANCED MEDICAL & WELLNESS OF SPRING HILL, S.C.
Entity type:Organization
Organization Name:ADVANCED MEDICAL & WELLNESS OF SPRING HILL, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-428-1515
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-0959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:231 W MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CARPENTERSVILLE
Practice Address - State:IL
Practice Address - Zip Code:60110-1788
Practice Address - Country:US
Practice Address - Phone:847-428-1515
Practice Address - Fax:847-428-0024
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED MEDICAL & WELLNESS OF SPRING HILL, S.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-26
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty