# MARLYN F GOLDBERG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629066519
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 036-096240 | IL | Yes |

## Other

- **Enumeration date:** 10/13/2005
- **Last updated:** 08/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 036088212 | LICENSE NUMBER | IL |
| 05 | — | 0360962402 | — | IL |
| 01 | — | 05626127 | BLUE CROSS BLUE SHIELD | IL |
| 01 | — | DA3012 | RAILROAD GROUP NUMBER | IL |
| 01 | — | P00048835 | RAILROAD MEDICARE | IL |