Individual
MR. RD EDWARD GOODWIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
284 E 16TH ST, CHICAGO HEIGHTS, IL 60411-3730
(708) 757-0455
Mailing address
284 E 16TH ST, CHICAGO HEIGHTS, IL 60411-3730
(708) 757-0455
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
G35072562083
IL
Other
Enumeration date
04/08/2009
Last updated
04/08/2009
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