| Umesh P. Goswami, Md Sc | |
|
625 Bethany Rd Suite 3 Dekalb IL 60115-4908 | |
| (815) 758-5100 | |
| (815) 758-5144 |
| Full Name | Umesh P. Goswami, Md Sc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 625 Bethany Rd, Dekalb, Illinois |
| Authorized Official Name and Position | Umesh P Goswami (OWNER) |
| Authorized Official Contact | 8157585100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Umesh P. Goswami, Md Sc 625 Bethany Rd Suite 3 Dekalb IL 60115-4908 Ph: (815) 758-5100 | Umesh P. Goswami, Md Sc 625 Bethany Rd Suite 3 Dekalb IL 60115-4908 Ph: (815) 758-5100 |
| NPI Number | 1033393889 |
|---|---|
| Provider Enumeration Date | 12/27/2007 |
| Last Update Date | 05/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033393889 | NPI | - | NPPES |
| 21609266 | Other | IL | BCBS |
| 036058246 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 042005119 (Illinois) | Primary |
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