Provider Demographics
NPI:1447318191
Name:ADVANCED HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:ADVANCED HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHALOW
Authorized Official - Suffix:
Authorized Official - Credentials:RRT, RPSGT
Authorized Official - Phone:708-372-3154
Mailing Address - Street 1:10646 165TH ST.
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5653
Mailing Address - Country:US
Mailing Address - Phone:708-364-9606
Mailing Address - Fax:708-364-9607
Practice Address - Street 1:680 N LAKE SHORE DR
Practice Address - Street 2:# 1210
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4546
Practice Address - Country:US
Practice Address - Phone:312-587-0926
Practice Address - Fax:708-364-9607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203000585332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203000585OtherSTATE LICENSE
IL203000585OtherSTATE LICENSE