Individual provider Active NPI

Mark L Goode, M.D.

  • Pulmonary Disease Physician
  • Berwyn, IL
National Provider Identifier
1023121167
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036089656 Issued in IL
Practice address
3231 Euclid Ave
Suite 405
Berwyn, IL 60402-3471
Phone
(708) 783-2644
Fax
(708) 783-0514
NPI assigned
Aug 15, 2006
Last updated
Dec 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036089656 IL
Pulmonary Disease Physician 207RP1001X 036089656 IL Primary

Addresses

Primary practice location

3231 Euclid Ave
Suite 405
Berwyn, IL 60402-3471

Mailing address

3231 Euclid Ave
Suite 405
Berwyn, IL 60402-3471
Phone (708) 783-2644

Other identifiers 3

IdentifierTypeStateIssuer
036089656MedicaidIL
110205012OtherILRAILROAD MEDICARE PIN
36089656OtherILSTATE OF ILLINOIS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041208001172 IL Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 0042276297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RML Health Providers Limited PartnershipGroup PAC ID 2961459565, 11 clinicians

Practice addresses (Care Compare)

5601 S County Line Rd
Hinsdale, IL 60521-4875
Phone (630) 286-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
RML Health Providers Limited Partnership CurrentSince Jul 1, 1999 Accepting new patients

Locations

3316 Payshere Cir
Chicago, IL 60674

3435 W Van Buren St
Chicago, IL 60624
Phone (773) 265-7700

5601 S County Line Rd
Hinsdale, IL 60521
Phone (630) 286-4000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1023121167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE",
            "address_2": "SUITE 405",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023471",
            "telephone_number": "708-783-2644",
            "fax_number": "708-783-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 EUCLID AVE",
            "address_2": "SUITE 405",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023471",
            "telephone_number": "708-783-2644",
            "fax_number": "708-783-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODE",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036089656",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036089656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089656",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "110205012",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS LICENSE",
            "identifier": "36089656",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.