MEDICARE: DR. NEELAM GOEL 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
1	208000000X	Pediatrics Physician		IL

General Provider Information

NPI Number	:	1457360828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEELAM GOEL MD

Provider Business Mailing Address
First Line	:	622 30TH ST
Second Line	:
City	:	PERU
State	:	IL
Zip	:	61354-1472
Country	:	US
Telephone Number	:	815-224-4188
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 WEST ST
Second Line	:	BUILDING A SUITE 116
City	:	PERU
State	:	IL
Zip	:	61354-2763
Country	:	US
Telephone Number	:	815-223-6222
Fax Number	:	815-223-3838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. NEELAM GOEL MD” Practice Location

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