Goldstein, Gregory T

Goldstein, Gregory T is an sole proprietor health care provider with primary practice located at 1638 W Surf St , Chicago IL 60657-3599. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Goldstein, Gregory T can be contacted via phone (312) 890-3999.

Contact Information

Primary practice address
1638 W Surf St Chicago IL 60657-3599
Phone: (312) 890-3999
Fax: (847) 919-3849
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036104855 Illinois

Profile Details

NPI number 1821063496
LBN Legal business name Goldstein, Gregory T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 17th, 2006
Last updated Jul 7th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821063496 NPPES
Illinois MEDICAID 036104855
Illinois Other 3001384006
Illinois Other CN0576
Illinois Other PTAN IL 1739
Illinois Other 1615479

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