Goodman, David

Goodman, David is an individual health care provider with primary practice located at 405 Illinois Ave Suite 2C, St Charles IL 60174-2963. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Goodman, David can be contacted via phone (630) 377-3535.

Contact Information

Primary practice address
405 Illinois Ave Suite 2C St Charles IL 60174-2963
Phone: (630) 377-3535
Fax: (630) 530-9527
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Illinois

Profile Details

NPI number 1669586897
LBN Legal business name Goodman, David
Credentials DAVID GOODMAN
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated Jul 8th, 2007 - about 17 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 1669586897 NPPES
Illinois Other 4572009 BC/BS PROVIDER NUMBER

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