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Individual

CHARLES GOOLSBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(312) 926-6948
(312) 926-0560
Mailing address
27W251 VIRGINIA ST, WINFIELD, IL 60190-1801

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary

Other

Enumeration date
04/09/2013
Last updated
04/09/2013
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