Individual
KEVIN JAMES GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
61541
MN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
36163802
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
4301506962
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2014
Last updated
02/07/2024
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