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General NPI Number Information
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NPI Number | 1750479804
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Entity Type | Individual
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Provider Name | VALERIE DAY GOODRICH M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 09/29/2020
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Provider Practice Location Address
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Address Line | 1701 W SUPERIOR ST
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City | CHICAGO
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State | IL
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Zip | 60622-5646
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Country | US
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Telephone | 312-666-3494
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Fax |
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Provider Business Mailing Address
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Address Line | 3511 N HERMITAGE AVE
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City | CHICAGO
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State | IL
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Zip | 60657-1217
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Country | US
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Telephone | 773-929-1803
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 336-060738
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 336-060738
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 336-060738
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License Number State | IL
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