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General NPI Number Information
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NPI Number | 1518281682
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Entity Type | Organization
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Legal Business Name | ADVANCE MIDWEST MEDICAL SC
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 1585 BARRINGTON ROAD SUITE 501
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-5020
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Country | US
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Telephone | 847-490-9800
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Fax | 847-490-8999
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Provider Business Mailing Address
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Address Line | 1585 BARRINGTON ROAD DOCTORS BUILDING 2 - SUITE 501
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-5020
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Country | US
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Telephone | 847-490-8900
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Fax | 847-490-8999
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAJIV SOOD
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Credential | MD
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Telephone | 847-490-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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