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NPI Code Detail

MEDICARE: COLIN GOODMAN MD

MEDICARE: COLIN GOODMAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036.147614IL

General Provider Information

NPI Number : 1275995722
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLIN GOODMAN MD
Provider Business Mailing Address
First Line : 840 S WOOD ST
Second Line : 440 CSN (MC 718)
City : CHICAGO
State : IL
Zip : 60612-4325
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1740 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-7232
Country : US
Telephone Number : 866-600-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2016
Last Update Date : 01/14/2026

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Directions to “ COLIN GOODMAN MD” Practice Location

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