P C Goodwin Medical Llc | |
9401 S Pulaski Rd Suite 101 Evergreen Park IL 60805-1924 | |
(708) 424-2475 | |
(708) 424-2494 |
Full Name | P C Goodwin Medical Llc |
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Speciality | Internal Medicine |
Location | 9401 S Pulaski Rd, Evergreen Park, Illinois |
Authorized Official Name and Position | Pamela Denise Goodwin-cole (PRESIDENT & CEO) |
Authorized Official Contact | 7084242475 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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P C Goodwin Medical Llc 18507 Indie Ct Hazel Crest IL 60429-2469 Ph: (708) 204-0786 | P C Goodwin Medical Llc 9401 S Pulaski Rd Suite 101 Evergreen Park IL 60805-1924 Ph: (708) 424-2475 |
NPI Number | 1013110444 |
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Provider Enumeration Date | 06/05/2007 |
Last Update Date | 09/17/2008 |
Identifier | Type | State | Issuer |
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1013110444 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036076189 (Illinois) | Primary |
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