Mr. Michael Joseph Gootee
Plastic Surgeon (Head & Neck)
420 Ne Glen Oak Ave
Peoria
, Illinois 61603-3105
Mr. Michael Joseph Gootee
Plastic Surgeon (Head & Neck)
420 Ne Glen Oak Ave
Peoria
, Illinois 61603-3105
(309) 655-3948
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About
Features
Specialties
- Plastic Surgeon (Head & Neck)
Languages spoken
- English
Location
First Address
- Mr. Michael Joseph Gootee
- 420 Ne Glen Oak Ave
- Peoria, IL
- Zip : 61603-3105
- Fax : (309) 655-3948
- Phone : (309) 655-4180
Second Address
- Mr. Michael Joseph Gootee
- 420 Ne Glen Oak Ave
- Peoria, IL
- Zip : 61603-3105
- Fax : (309) 655-3948
- Phone : (309) 655-4180
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 036090454 | IL |
National Provider Identifier
| NPI | 1720050982 |
|---|---|
| Provider Name | Mr. Michael Joseph Gootee |
| First Address | Peoria, IL 61603-3105 |
| Second Address | Peoria, IL 61603-3105 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/02/2006 |
| Last Update Date | 20/03/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036090454 | (05) | IL |
| G07448 | (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.