Provider Demographics
NPI:1083721716
Name:ADVANCED MEDICAL ASSOCIATES, SC
Entity type:Organization
Organization Name:ADVANCED MEDICAL ASSOCIATES, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PRITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:GOOMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-446-8785
Mailing Address - Street 1:5875 N LINCOLN AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4672
Mailing Address - Country:US
Mailing Address - Phone:312-446-8785
Mailing Address - Fax:773-890-1199
Practice Address - Street 1:5875 N LINCOLN AVE STE 105
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4672
Practice Address - Country:US
Practice Address - Phone:312-446-8785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085U0001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty