Avanti Medical Group of Minnesota LLC

NPI #1326357500 in Wheaton, Illinois

Provider Information

NPI Number: 1326357500
Entity Type: Organization
Organization Name: Avanti Medical Group of Minnesota LLC
Subpart: Yes (part of a larger organization)
Parent Organization: AVANTI MEDICAL GROUP
Primary Specialty: Clinic/Center
Enumeration Date: Oct 5, 2010
Last Updated: Oct 5, 2010

Practice Location

Address: 1755 S NAPERVILLE RD
Address 2: SUITE 100
City: Wheaton
State: Illinois
ZIP Code: 60189-5844
Phone: (318) 465-5874

Authorized Official

Name: AMY GRAHAM, RN, BSN
Title: VICE PRESIDENT OF MEDICAL AFFAIRS
Phone: (318) 465-5874

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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