Dr. Eli G Goodman
Geriatric Medicine
1600 W Walnut St
Jacksonville
, Illinois 62650-1136
Dr. Eli G Goodman
Geriatric Medicine
1600 W Walnut St
Jacksonville
, Illinois 62650-1136
(217) 479-5890
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Eli G Goodman
- 1600 W Walnut St
- Jacksonville, IL
- Zip : 62650-1136
- Phone : (217) 479-5890
Second Address
- Dr. Eli G Goodman
- 1600 W Walnut St
- Jacksonville, IL
- Zip : 62650-1136
- Phone : (217) 479-5890
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | 036113160 | IL |
National Provider Identifier
| NPI | 1053405589 |
|---|---|
| Provider Name | Dr. Eli G Goodman |
| First Address | Jacksonville, IL 62650-1136 |
| Second Address | Jacksonville, IL 62650-1136 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/10/2006 |
| Last Update Date | 21/12/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| D98448 | (02) | |
| O04721 | (02) |
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.