Goodell, Pamela Pineda

Goodell, Pamela Pineda is an individual health care provider with primary practice located at 221 Ne Glen Oak Ave Department Of Pathology, Peoria IL 61636-0001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Goodell, Pamela Pineda can be contacted via phone (309) 672-4964.

Contact Information

Primary practice address
221 Ne Glen Oak Ave Department Of Pathology Peoria IL 61636-0001
Fax:
Website:

Profile Details

NPI number 1154580447
LBN Legal business name Goodell, Pamela Pineda
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2008
Last updated Aug 13th, 2012 - about 14 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 1154580447 NPPES
Illinois MEDICAID 03612845801
Illinois Other P00971579

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