Organization
ADVANCED GYNECOLOGY, S.C.
Active
Other names
Advanced Gynecology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOGOL JAHEDI JIMENEZ MD (OWNER AND PHYSICIAN)
(847) 568-1488
Entity
Organization
Contact information
Practice address
250 W KENSINGTON RD STE 1B, MT PROSPECT, IL 60056-1292
(847) 568-1488
(847) 749-2695
Mailing address
250 W KENSINGTON RD STE 1B, MT PROSPECT, IL 60056-1292
(847) 568-1488
(847) 749-2695
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
042-619903
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042-619903
STATE LICENSE OF MEDICAL CORPORATION
IL
Enumeration date
01/17/2012
Last updated
08/24/2018
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