Individual
BRUCE D GOLDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5425 W LAWRENCE AVE, CHICAGO, IL 60630-3404
(773) 725-7557
(773) 794-0138
Mailing address
5425 W LAWRENCE AVE, CHICAGO, IL 60630-3404
(773) 725-7557
(773) 794-0138
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036069603
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036069603
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
75779
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100325817
—
WI
Enumeration date
08/18/2006
Last updated
07/29/2025
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