Provider Demographics
NPI:1982879573
Name:ADVANCED PHYSICIANS NETWORK, INC.
Entity type:Organization
Organization Name:ADVANCED PHYSICIANS NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEOPOLCO
Authorized Official - Middle Name:L
Authorized Official - Last Name:JURADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-874-1666
Mailing Address - Street 1:326 W 64TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60621-3114
Mailing Address - Country:US
Mailing Address - Phone:773-317-0905
Mailing Address - Fax:773-874-7701
Practice Address - Street 1:326 W 64TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-3114
Practice Address - Country:US
Practice Address - Phone:773-317-0905
Practice Address - Fax:773-874-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization