| Maria Goldstein, Pc | |
|
550 E Boughton Rd Ste 205 Bolingbrook IL 60440-2396 | |
| (312) 924-1884 | |
| Not Available |
| Full Name | Maria Goldstein, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 550 E Boughton Rd Ste 205, Bolingbrook, Illinois |
| Authorized Official Name and Position | Maria Goldstein (PRESIDENT) |
| Authorized Official Contact | 6303335487 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maria Goldstein, Pc 2913 Manchester Dr Montgomery IL 60538-4063 Ph: (630) 333-5487 | Maria Goldstein, Pc 550 E Boughton Rd Ste 205 Bolingbrook IL 60440-2396 Ph: (312) 924-1884 |
| NPI Number | 1225735392 |
|---|---|
| Provider Enumeration Date | 02/09/2023 |
| Last Update Date | 02/09/2023 |
| Certification Date | 02/09/2023 |
| Medicare PECOS PAC ID | 7315302072 |
|---|---|
| Medicare Enrollment ID | O20230502001724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225735392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Maria Goldstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104588722 PECOS PAC ID: 8224493986 Enrollment ID: I20230502001772 |
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