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Individual

RICHARD STUART GOLDBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8311 ROOSEVELT RD, FOREST PARK, IL 60130-2529
(708) 814-6600
(708) 209-2283
Mailing address
PO BOX 5230, RIVER FOREST, IL 60305-5230
(708) 814-6600
(630) 920-9095

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
036056868
IL
2084F0202X
Forensic Psychiatry Physician
036056868
IL
2084P0800X
Psychiatry Physician
Primary
036056868
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
363148505-60611-01
IL
Enumeration date
10/13/2006
Last updated
10/06/2010
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