Doctor Name: | DR. WILLIAM RICHARD GOODELL |
NPI Number: | 1023054731 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036-077-566 |
Business Practice Address: | 1675 Dempster St 2nd Floor Park Ridge, IL - 600681110 |
Business Phone Number: | 8473189330 |
Business Fax Number: | 8477238523 |
Mailing Address: | 701 Lee St, DES PLAINES |
State: | IL |
Postal Code: | 600164539 |
Phone Number: | 8473905900 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2006 |
NPI Last Update Date: | 12/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2080P0207X |
License Number: | 036-077-566 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Pediatrics |
Taxonomy Specialization: | Pediatric Hematology-Oncology |
Taxonomy Definition: | A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |