Organization
ADVANCED GYNECOLOGY PRACTICE LLC
Active
Other names
Advanced Endometriosis center, Advanced Care & Medspa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FADEL FONS TALASOUN AZER MD (MEMBER/OWNER)
(331) 702-2455
Entity
Organization
Contact information
Practice address
3033 OGDEN AVE STE 300, LISLE, IL 60532-1976
(331) 702-2455
(331) 229-8191
Mailing address
3033 OGDEN AVE STE 300, LISLE, IL 60532-1976
(331) 702-2455
(331) 229-8191
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207VG0400X
Gynecology Physician
Primary
—
—
Other
Enumeration date
02/10/2023
Last updated
05/01/2024
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