Individual
DIANA GOLDAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
3855 N PARKWAY DR APT 3A, NORTHBROOK, IL 60062-7218
(847) 239-3654
Mailing address
3855 N PARKWAY DR APT 3A, NORTHBROOK, IL 60062-7218
(847) 239-3654
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
238000628
IL
Other
Enumeration date
05/20/2020
Last updated
06/03/2020
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