Individual
DR. JYOTHI GOGINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10370 HALIGUS RD STE 117, HUNTLEY, IL 60142
(815) 338-6600
(847) 702-7207
Mailing address
10370 HALIGUS RD STE 117, HUNTLEY, IL 60142-9582
(815) 338-6600
(847) 702-7207
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036-122492
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036122492
STATE LICENSE
IL
Enumeration date
08/14/2007
Last updated
10/19/2018
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