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General NPI Number Information
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NPI Number | 1811138076
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Entity Type | Organization
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Legal Business Name | GEORGE W. GOODLOW, MD, PEDIATRICS, LLC
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 05/08/2009
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Provider Practice Location Address
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Address Line | 3295 N ARLINGTON HEIGHTS RD SUITE 106-107
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-1565
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Country | US
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Telephone | 847-797-0587
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Fax | 847-797-1020
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Provider Business Mailing Address
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Address Line | 3295 N ARLINGTON HEIGHTS RD SUITE 107
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-1565
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Country | US
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Telephone | 847-797-0587
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Fax | 847-797-1020
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Authorized Official
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Title or Position | OWNER
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Name | GEORGE W. GOODLOW
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Credential | MD
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Telephone | 847-797-0587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036-050051
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License Number State | IL
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