Gotardo, Carlos F

Gotardo, Carlos F is an individual health care provider with primary practice located at 707 N Logan Ave , Danville IL 61832-4360. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Gotardo, Carlos F can be contacted via phone (217) 446-6410.

Contact Information

Primary practice address
707 N Logan Ave Danville IL 61832-4360
Fax: (217) 477-4757
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036059520 Illinois

Profile Details

NPI number 1285674564
LBN Legal business name Gotardo, Carlos F
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Nov 24th, 2009 - about 15 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 1285674564 NPPES
Illinois MEDICAID 036059520
Illinois Other 247880
Illinois MEDICAID 100014860A
Illinois Other 170579

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