Individual
MICHAEL GOODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1808 N HALSTED ST, CHICAGO, IL 60614-5007
(312) 618-4867
Mailing address
7002 FOXFIRE DR, CRYSTAL LAKE, IL 60012-1656
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.009739
IL
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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