Provider Demographics
NPI:1568658409
Name:ADVANCED PHYSICIANS HEALTH CARE S.C.
Entity type:Organization
Organization Name:ADVANCED PHYSICIANS HEALTH CARE S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:DURBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:309-688-4484
Mailing Address - Street 1:350 CIMMERON DR
Mailing Address - Street 2:
Mailing Address - City:EAST PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61611-7511
Mailing Address - Country:US
Mailing Address - Phone:309-688-4484
Mailing Address - Fax:309-263-4611
Practice Address - Street 1:350 CIMMERON DR
Practice Address - Street 2:
Practice Address - City:EAST PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61611-7511
Practice Address - Country:US
Practice Address - Phone:309-688-4484
Practice Address - Fax:309-688-4485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1568658409OtherADVANCED PHYSICIAN HEALTH CARE S.C.
IL1154486983OtherCHRISTY NIP
IL1154486983OtherCHRISTY NIP