| Advanced Liver And Gastrointestinal Disease Center Llc | |
|
3245 Grove Ave Berwyn IL 60402-3474 | |
| (414) 236-7224 | |
| (708) 290-1014 |
| Full Name | Advanced Liver And Gastrointestinal Disease Center Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3245 Grove Ave, Berwyn, Illinois |
| Authorized Official Name and Position | David H Vanthiel (PRESIDENT) |
| Authorized Official Contact | 3125731633 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Liver And Gastrointestinal Disease Center Llc 401 E Ontario St Suite#4005 Chicago IL 60611-3051 Ph: (312) 573-1633 | Advanced Liver And Gastrointestinal Disease Center Llc 3245 Grove Ave Berwyn IL 60402-3474 Ph: (414) 236-7224 |
| NPI Number | 1841552999 |
|---|---|
| Provider Enumeration Date | 06/14/2012 |
| Last Update Date | 07/17/2023 |
| Medicare PECOS PAC ID | 7810140225 |
|---|---|
| Medicare Enrollment ID | O20130116000123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841552999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | IL036096121 (Illinois) | Primary |
| 207RI0008X | Internal Medicine - Hepatology | IL036096121 (Illinois) | Secondary |
| Provider Name | David H Van Thiel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447367479 PECOS PAC ID: 3779573399 Enrollment ID: I20050804000391 |
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