Dr. Edward J. Goldberg
Orthopaedic Spine Surgeon
1611 W Harrison St Ste 400
Chicago
, Illinois 60612-3841
Dr. Edward J. Goldberg
Orthopaedic Spine Surgeon
1611 W Harrison St Ste 400
Chicago
, Illinois 60612-3841
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About
Features
Specialties
- Orthopaedic Spine Surgeon
Languages spoken
- English
Location
First Address
- Dr. Edward J. Goldberg
- 1 Westbrook Corporate Ctr #240
- Westchester, IL
- Zip : 60154-5701
- Phone :
Second Address
- Dr. Edward J. Goldberg
- 1611 W Harrison St Ste 400
- Chicago, IL
- Zip : 60612-3841
- Fax : (312) 942-1517
- Phone : (312) 243-4244
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XS0117X | Orthopaedic Spine Surgeon | 036070258 | IL |
National Provider Identifier
| NPI | 1407835176 |
|---|---|
| Provider Name | Dr. Edward J. Goldberg |
| First Address | Westchester, IL 60154-5701 |
| Second Address | Chicago, IL 60612-3841 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/01/2006 |
| Last Update Date | 18/09/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036070258 3 | (05) | IL |
| 1633878 | BCBS GROUP ID# (01) | IL |
| 207067 | MEDICARE PTAN LOCALITY 16 (01) | IL |
| 207073 | MEDICARE PTAN LOCALITY 15 (01) | IL |
| 4122886 | AETNA ID# (01) | IL |
| DA4902 | RR MEDICARE PTAN# (01) | IL |
| E18473 | (02) | IL |
| P00150808 | RR MEDICARE ID# (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.