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Individual

RAYMOND GOUTTAMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1375 E SCHAUMBURG RD, SUITE 260, SCHAUMBURG, IL 60194-5166
(847) 895-4540
Mailing address
1375 E SCHAUMBURG RD, SUITE 260, SCHAUMBURG, IL 60194-5166
(847) 895-4540

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036068607
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036068607
IL
01
1617631
BLUE CROSS BLUE SHIELD
IL
01
202591
MEDICARE
IL
01
R03464
MEDICARE
IL
Enumeration date
12/05/2006
Last updated
06/22/2012
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