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Individual

DR. CARMEL LYNN GOUDZWAARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
25 N. WINFIELD RD., WINFIELD, IL 60190-1295
(630) 933-4700
(630) 933-4427
Mailing address
25 N. WINFIELD RD., WINFIELD, IL 60190-1295
(630) 933-4700
(630) 933-4427

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036123732
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036123732
IL
207RP1001X
Pulmonary Disease Physician
036123732
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036123732
IL
01
206147
MEDICARE PTAN (GROUP)
IL
01
206147112
MEDICARE PTAN (INDIVIDUAL)
IL
01
P01144148
RAILROAD MEDICARE INDIVIDUAL PTAN
IL
Enumeration date
08/18/2008
Last updated
04/09/2013
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