| J I Goldman Md Pc | |
|
4646 N Marine Dr B 125 Chicago IL 60640-5759 | |
| (773) 572-0032 | |
| (773) 572-0029 |
| Full Name | J I Goldman Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4646 N Marine Dr, Chicago, Illinois |
| Authorized Official Name and Position | Jaroslav Goldman (PRESIDENT) |
| Authorized Official Contact | 3127874916 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J I Goldman Md Pc 33 W Ontario St Apt 36b Chicago IL 60654-7771 Ph: (312) 787-4916 | J I Goldman Md Pc 4646 N Marine Dr B 125 Chicago IL 60640-5759 Ph: (773) 572-0032 |
| NPI Number | 1144340308 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 12/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144340308 | NPI | - | NPPES |
| 036100764 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036100764 (Illinois) | Primary |
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