Goldberg, Edward J.

Goldberg, Edward J. is an individual health care provider with primary practice located at 1611 W Harrison St Ste 400, Chicago IL 60612-3841. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, which is considered as his primary health care specialty. Goldberg, Edward J. can be contacted via phone (312) 243-4244.

Contact Information

Primary practice address
1611 W Harrison St Ste 400 Chicago IL 60612-3841
Phone: (312) 243-4244
Fax: (312) 942-1517
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X 036070258 Illinois

Profile Details

NPI number 1407835176
LBN Legal business name Goldberg, Edward J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2006
Last updated Sep 18th, 2018 - about 6 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 1407835176 NPPES
Illinois Other 207067 MEDICARE PTAN LOCALITY 16
Illinois Other DA4902 MEDICARE PTAN LOCALITY 16
Illinois Other P00150808 MEDICARE PTAN LOCALITY 16
Illinois MEDICAID 036070258 3 MEDICARE PTAN LOCALITY 16
Illinois Other 207073 MEDICARE PTAN LOCALITY 16
Illinois Other 4122886 MEDICARE PTAN LOCALITY 16
Illinois Other 1633878 MEDICARE PTAN LOCALITY 16

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