Doctor Name: | DR. JAMES R GOLDSTONE |
NPI Number: | 1225108194 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 036051423 |
Business Practice Address: | 1640 Maple Ave Suite 1602 Evanston, IL - 602013667 |
Business Phone Number: | 8478596070 |
Business Fax Number: | |
Mailing Address: | 1640 Maple Ave, Suite 1602 EVANSTON |
State: | IL |
Postal Code: | 602013667 |
Phone Number: | 8478596070 |
Fax Number: | |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 04/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036051423 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |