Individual
CYNTHIA L GOLDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
581 WILLIAM LATHAM DR, SUITE 103, BOURBONNAIS, IL 60914-2317
(815) 929-9700
(815) 929-9797
Mailing address
581 WILLIAM LATHAM DR, SUITE 103, BOURBONNAIS, IL 60914-2317
(815) 929-9700
(815) 929-9797
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000881
IL
363AS0400X
Surgical Physician Assistant
085000881
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085000881
—
IL
Enumeration date
12/20/2010
Last updated
12/20/2010
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