Provider Demographics
NPI:1447545579
Name:ADVANCED BEHAVIORAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:ADVANCED BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETRIT
Authorized Official - Middle Name:
Authorized Official - Last Name:NDRIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-689-1022
Mailing Address - Street 1:1952 MC DOWELL RD STE 305
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-6507
Mailing Address - Country:US
Mailing Address - Phone:630-689-1022
Mailing Address - Fax:866-441-1136
Practice Address - Street 1:1952 MC DOWELL RD STE 305
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-6507
Practice Address - Country:US
Practice Address - Phone:630-689-1022
Practice Address - Fax:866-441-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1104952084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty