Healthcare Provider Details

I. General information

NPI: 1083721716
Provider Name (Legal Business Name): ADVANCED MEDICAL ASSOCIATES, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 N LINCOLN AVE STE 105
CHICAGO IL
60659-4672
US

IV. Provider business mailing address

5875 N LINCOLN AVE STE 105
CHICAGO IL
60659-4672
US

V. Phone/Fax

Practice location:
  • Phone: 312-446-8785
  • Fax:
Mailing address:
  • Phone: 312-446-8785
  • Fax: 773-890-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: PRITH M GOOMAR
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 312-446-8785