| David Goodman, Ph.d. Psychologist Associates | |
|
405 Illinois Ave Suite 2c St Charles IL 60174-2963 | |
| (630) 377-3535 | |
| (630) 530-9527 |
| Full Name | David Goodman, Ph.d. Psychologist Associates |
|---|---|
| Speciality | Psychologist |
| Location | 405 Illinois Ave, St Charles, Illinois |
| Authorized Official Name and Position | David M. Goodman (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 6303773535 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David Goodman, Ph.d. Psychologist Associates 405 Illinois Ave Suite 2c St Charles IL 60174-2963 Ph: (630) 377-3535 | David Goodman, Ph.d. Psychologist Associates 405 Illinois Ave Suite 2c St Charles IL 60174-2963 Ph: (630) 377-3535 |
| NPI Number | 1659485878 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 05/29/2009 |
| Medicare PECOS PAC ID | 7416909056 |
|---|---|
| Medicare Enrollment ID | O20050211000491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659485878 | NPI | - | NPPES |
| 4572009 | Other | IL | BC/BS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071002731 (Illinois) | Primary |
| Provider Name | David M Goodman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669586897 PECOS PAC ID: 8022060672 Enrollment ID: I20050214000094 |
| Provider Name | Rosemary Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194839233 PECOS PAC ID: 1557537750 Enrollment ID: I20120109000957 |
| Provider Name | Perry Dennis Weingart |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851643555 PECOS PAC ID: 0042564536 Enrollment ID: I20181120001214 |
| Provider Name | Karen A. Baker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508215286 PECOS PAC ID: 7911251400 Enrollment ID: I20181120001342 |
| Provider Name | Sharmistha Bose |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235137050 PECOS PAC ID: 9335493832 Enrollment ID: I20181120001590 |
| Provider Name | Evelyn M Connelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659655595 PECOS PAC ID: 3678817848 Enrollment ID: I20181129002016 |
| Provider Name | Tamara A Spratley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174535702 PECOS PAC ID: 3173587789 Enrollment ID: I20190514001941 |
| Provider Name | Nicholas G. Lattanzio |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346901667 PECOS PAC ID: 1658721824 Enrollment ID: I20231229002218 |
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