Individual
EMILY GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
2650 RIDGE AVE., DEPARTMENT OF PEDIATRICS, EVANSTON, IL 60201-1781
(847) 570-2033
Mailing address
2650 RIDGE AVE., DEPARTMENT OF PEDIATRICS, EVANSTON, IL 60201-1781
(847) 570-2033
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209024926
IL
363LP0200X
Pediatric Nurse Practitioner
RN290081
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN290081
—
GA
Enumeration date
02/26/2021
Last updated
05/03/2022
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