Individual
MARLYN F GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036-096240
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036088212
LICENSE NUMBER
IL
05
—
0360962402
—
IL
01
—
05626127
BLUE CROSS BLUE SHIELD
IL
01
—
DA3012
RAILROAD GROUP NUMBER
IL
01
—
P00048835
RAILROAD MEDICARE
IL
Enumeration date
10/13/2005
Last updated
08/07/2023
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