Provider Demographics
NPI:1679043541
Name:ADVANCE PRACTITIONERS IN HEALTH,INC.
Entity type:Organization
Organization Name:ADVANCE PRACTITIONERS IN HEALTH,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:630-398-1935
Mailing Address - Street 1:1000 INGLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-4942
Mailing Address - Country:US
Mailing Address - Phone:630-398-1935
Mailing Address - Fax:630-282-7468
Practice Address - Street 1:1000 INGLEWOOD LN
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-4942
Practice Address - Country:US
Practice Address - Phone:630-398-1935
Practice Address - Fax:630-282-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty