Provider Demographics
NPI:1366077570
Name:ADVANCED INTEGRATED MEDICAL THERAPY INC.
Entity type:Organization
Organization Name:ADVANCED INTEGRATED MEDICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:733-881-3400
Mailing Address - Street 1:9727 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-1723
Mailing Address - Country:US
Mailing Address - Phone:773-881-3400
Mailing Address - Fax:
Practice Address - Street 1:9727 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1723
Practice Address - Country:US
Practice Address - Phone:773-881-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology