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General NPI Number Information
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NPI Number | 1700145331
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Entity Type | Individual
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Provider Name | JACOB ZE'EV BARNETT GOLDSMITH PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 2652 W COYLE AVE
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City | CHICAGO
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State | IL
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Zip | 60645-3215
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Country | US
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Telephone | 773-354-2652
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Fax |
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Provider Business Mailing Address
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Address Line | 2652 W COYLE AVE
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City | CHICAGO
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State | IL
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Zip | 60645-3215
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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