Individual
JEFFREY A GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036108837
IL
207RI0011X
Interventional Cardiology Physician
Primary
036-108837
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00013594
RAILROAD
IL
05
—
036108837
—
IL
Enumeration date
10/19/2006
Last updated
03/10/2025
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