Individual
MARYAN GODOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4440 W 95TH ST FL 8, OAK LAWN, IL 60453-2600
(708) 684-4200
(708) 520-1885
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
(847) 390-4757
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209025353
IL
363LP2300X
Primary Care Nurse Practitioner
209025353
IL
Other
Enumeration date
07/01/2022
Last updated
02/28/2025
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