Individual
ELLEN GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
924 E 57TH ST STE 104, CHICAGO, IL 60637-1455
(773) 702-1939
Mailing address
924 E 57TH ST STE 104, CHICAGO, IL 60637-1455
(773) 702-1939
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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