MEDICARE: PEARL GOVEA M.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	207Q00000X	Family Medicine Physician	0101235022	VA
2	207Q00000X	Family Medicine Physician	MD.32028	AL
3	207Q00000X	Family Medicine Physician	N6225	TX
4	207Q00000X	Family Medicine Physician	ME110535	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336123587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEARL GOVEA M.D.

Provider Business Mailing Address
First Line	:	1340 S DAMEN AVE
Second Line	:	SUITE 400
City	:	CHICAGO
State	:	IL
Zip	:	60608-1169
Country	:	US
Telephone Number	:	773-292-4800
Fax Number	:	312-564-4059

Provider Business Practice Location Address
First Line	:	2 CHASE CORPORATE DR
Second Line	:	SUITE 300
City	:	HOOVER
State	:	AL
Zip	:	35244-1016
Country	:	US
Telephone Number	:	773-292-4800
Fax Number	:	312-564-4059

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	08/15/2016

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