MEDICARE: MRS. BARBARA LIVINGSTON-GOSCHI PSY D

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
1	103TC0700X	Clinical Psychologist	071-004675	IL

General Provider Information

NPI Number	:	1043424146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA LIVINGSTON-GOSCHI PSY D

Provider Business Mailing Address
First Line	:	525 FOREST AVE
Second Line	:
City	:	WILMETTE
State	:	IL
Zip	:	60091-1923
Country	:	US
Telephone Number	:	847-920-1993
Fax Number	:

Provider Business Practice Location Address
First Line	:	480 N MCCLURG CT
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4326
Country	:	US
Telephone Number	:	312-595-1787
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	07/08/2007

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