Godbolt, Sherrie Cecile

Godbolt, Sherrie Cecile is an individual health care provider with primary practice located at 15475 S Park Ave Suite 111, South Holland IL 60473-1328. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Godbolt, Sherrie Cecile can be contacted via phone (708) 362-5084.

Contact Information

Primary practice address
15475 S Park Ave Suite 111 South Holland IL 60473-1328
Phone: (708) 362-5084
Fax: (708) 596-6985
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 036098066 Illinois
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01048641A Indiana
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X 036098066 Illinois
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X 01048641A Indiana

Profile Details

NPI number 1114027828
LBN Legal business name Godbolt, Sherrie Cecile
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2006
Last updated Jan 14th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114027828 NPPES
Indiana MEDICAID 200197180
Indiana MEDICAID 036098066
Indiana Other 01625468

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