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NPI Code Detail

MEDICARE: ELIEEN Z GOOD MWF

MEDICARE: ELIEEN Z GOOD MWF
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
1367A00000XAdvanced Practice MidwifeIL

General Provider Information

NPI Number : 1619053402
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIEEN Z GOOD MWF
Provider Business Mailing Address
First Line : 1276 N CLYBOURN
Second Line :
City : CHICAGO
State : IL
Zip : 60610
Country : US
Telephone Number : 312-337-1073
Fax Number : 312-337-7616
Provider Business Practice Location Address
First Line : 4259 S BERKELEY AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60653-3030
Country : US
Telephone Number : 773-268-7600
Fax Number : 773-268-9088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2006
Last Update Date : 03/07/2023

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Directions to “ ELIEEN Z GOOD MWF” Practice Location

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