Organization Active NPI

Julie S Goldberg MD SC

  • Dermatology Physician
  • Northbrook, IL
National Provider Identifier
1053591123
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
JULIE S GOLDBERG MD SC
Practice address
513 Waukegan Rd
Northbrook, IL 60062
Phone
(847) 205-0007
Fax
(847) 205-0099
NPI assigned
Nov 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Authorized official

Name
Dr. Julie S Goldberg, MD
Title
Owner Physician
Phone
(847) 205-0007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X IL Primary

Addresses

Primary practice location

513 Waukegan Rd
Northbrook, IL 60062

Mailing address

513 Waukegan Rd
Northbrook, IL 60062
Phone (847) 205-0007

National Provider Directory

National Provider Directory

Locations

513 Waukegan Rd
Northbrook, IL 60062
Phone (847) 205-0007

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1053591123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 WAUKEGAN RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60062",
            "telephone_number": "847-205-0007",
            "fax_number": "847-205-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 WAUKEGAN RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60062",
            "telephone_number": "847-205-0007",
            "fax_number": "847-205-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE S GOLDBERG MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "847-205-0007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.