| Richard S. Goldberg, M.d., Ltd. | |
|
8311 Roosevelt Rd Optional Forest Park IL 60130-2529 | |
| (708) 814-6600 | |
| (630) 920-9095 |
| Full Name | Richard S. Goldberg, M.d., Ltd. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8311 Roosevelt Rd, Forest Park, Illinois |
| Authorized Official Name and Position | Richard Goldberg (PRESIDENT) |
| Authorized Official Contact | 7088146600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard S. Goldberg, M.d., Ltd. 8311 Roosevelt Rd Optional Forest Park IL 60130-2529 Ph: (708) 814-6600 | Richard S. Goldberg, M.d., Ltd. 8311 Roosevelt Rd Optional Forest Park IL 60130-2529 Ph: (708) 814-6600 |
| NPI Number | 1427353184 |
|---|---|
| Provider Enumeration Date | 01/11/2011 |
| Last Update Date | 01/11/2011 |
| Medicare PECOS PAC ID | 4284815036 |
|---|---|
| Medicare Enrollment ID | O20110225000883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427353184 | NPI | - | NPPES |
| 036056868 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036056868 (Illinois) | Primary |
| Provider Name | Richard S Goldberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356431720 PECOS PAC ID: 6002097854 Enrollment ID: I20110225000885 |
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