MEDICARE: EMILY FRANCES GODEC 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	207Q00000X	Family Medicine Physician	4301085801	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00663344	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0805211342	OTHER	MI	BCBS OF MICHIGAN

General Provider Information

NPI Number	:	1285851840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY FRANCES GODEC MD

Provider Business Mailing Address
First Line	:	4602 DEPT
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60122-0021
Country	:	US
Telephone Number	:	906-225-3864
Fax Number	:	906-225-3851

Provider Business Practice Location Address
First Line	:	5087 US 41 S
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-9001
Country	:	US
Telephone Number	:	906-225-5589
Fax Number	:

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	04/21/2009

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