Individual provider Active NPI

Judith Miriam Goykhman, APN

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1063167849
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.024812 Issued in IL
Practice address
1509 N Western Ave Unit a
Chicago, IL 60622-2416
Phone
(773) 227-3303
NPI assigned
Feb 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.024812 IL Primary

Addresses

Primary practice location

1509 N Western Ave Unit a
Chicago, IL 60622-2416

Mailing address

1509 N Western Ave Unit a
Chicago, IL 60622-2416
Phone (773) 227-3303

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL DHS Health Information Exchange (HIE)

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250326002785 IL Practitioner - Nurse Practitioner 8022531441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Primary Care S.C.Group PAC ID 6204925415, 8 clinicians

Practice addresses (Care Compare)

1900 Hollister Dr
Suite 250
Libertyville, IL 60048-5249
Phone (847) 573-9663

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.024812ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Primary Care S.C. CurrentSince Mar 1, 2025 Accepting new patients
M Chavez MD SC CurrentSince Oct 20, 2024 Accepting new patients

Locations

1900 Hollister Dr
Ste 250
Libertyville, IL 60048
Phone (847) 549-0055

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFFGBA/Endpoint/CFFGBA
  • FHIR API: https://api.platform.athenahealth.com/21778/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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

Hospital & facility affiliations 3

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": "1645228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1063167849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 N WESTERN AVE UNIT A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222416",
            "telephone_number": "773-227-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 N WESTERN AVE UNIT A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222416",
            "telephone_number": "773-227-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOYKHMAN",
        "first_name": "JUDITH",
        "middle_name": "MIRIAM",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-19",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.024812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "DHS",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2409 N Clybourn Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606146185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.