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General NPI Number Information
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NPI Number | 1780211573
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Entity Type | Individual
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Provider Name | ADAM JACOB GOODCOFF DO
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Gender | Male
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 1740 W TAYLOR ST
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City | CHICAGO
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State | IL
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Zip | 60612-7232
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Country | US
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Telephone | 866-600-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-0000
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Fax | 410-500-4266
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO210001759
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 125.076235
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License Number State | IL
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