| Innovative Advanced Practice Llc | |
|
4050 Healthway Dr Ste 140 Aurora IL 60504-8184 | |
| (630) 549-5429 | |
| (773) 912-6727 |
| Full Name | Innovative Advanced Practice Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4050 Healthway Dr Ste 140, Aurora, Illinois |
| Authorized Official Name and Position | Ednesha Ramey (CO-OWNER/NURSE PRACTITIONER) |
| Authorized Official Contact | 6305495429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Advanced Practice Llc 4050 Healthway Dr Ste 140 Aurora IL 60504-8184 Ph: (630) 549-5429 | Innovative Advanced Practice Llc 4050 Healthway Dr Ste 140 Aurora IL 60504-8184 Ph: (630) 549-5429 |
| NPI Number | 1881361335 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 05/22/2023 |
| Certification Date | 05/22/2023 |
| Medicare PECOS PAC ID | 6901297316 |
|---|---|
| Medicare Enrollment ID | O20211220000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881361335 | NPI | - | NPPES |
| 1609354133 | Medicaid | IL |
| Provider Name | Raymond Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609354133 PECOS PAC ID: 7911246996 Enrollment ID: I20190308002759 |
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