MEDICARE: RACHEL GOODMAN MD

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	208000000X	Pediatrics Physician	036093612	IL

General Provider Information

NPI Number	:	1205901816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL GOODMAN MD

Provider Business Mailing Address
First Line	:	572 LINCOLN AVE
Second Line	:	SUITE # 3
City	:	WINNETKA
State	:	IL
Zip	:	60093-2308
Country	:	US
Telephone Number	:	847-501-4040
Fax Number	:	847-501-4075

Provider Business Practice Location Address
First Line	:	572 LINCOLN AVE
Second Line	:	SUITE # 3
City	:	WINNETKA
State	:	IL
Zip	:	60093-2308
Country	:	US
Telephone Number	:	847-501-4040
Fax Number	:	847-501-4075

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	03/05/2012

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