Umesh P. Goswami, MD SC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

042005119 Issued in IL

Legal business name

UMESH P. GOSWAMI, MD SC

Practice address

625 Bethany Rd
Suite 3
Dekalb, IL 60115-4908

Phone

(815) 758-5100

Fax

(815) 758-5144

NPI assigned

Dec 27, 2007

Last updated

May 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Umesh P Goswami, MD

Title

Owner

Phone

(815) 758-5100

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Panna U Goswami, MD

  • Physical Medicine & Rehabilitation Physician
  • Normal, IL
  • NPI 1871587303
  NPD (past)
• Mayuri Morker, MD

  • Pediatrics Physician
  • Dekalb, IL
  • NPI 1598059982
  NPD (past)

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1033393889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BETHANY RD",
            "address_2": "SUITE 3",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601154908",
            "telephone_number": "815-758-5100",
            "fax_number": "815-758-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 BETHANY RD",
            "address_2": "SUITE 3",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601154908",
            "telephone_number": "815-758-5100",
            "fax_number": "815-758-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMESH P. GOSWAMI, MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "GOSWAMI",
        "authorized_official_first_name": "UMESH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-758-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "042005119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "21609266",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058246",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Trutt
• Victoria Tullock, MSW
• Elizabeth Marie Turner, MPH, RD, LDN
• Zachary Uecker
• Umesh P. Goswami MD SC (Progressive Physical Medicine)
• Shannon Michelle Underwood, MS ED, NCC, LCPC
• Gina Lynn Urnikis
• Abigail Valdez
• Jacqueline Renee Valdez, M.S.
• Pablo Valencia-Garcia

• Primary Care Clinic/Center in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.