Diana Goldak, PHYSICIAN ASSISTANT

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

238000628 Issued in IL

Practice address

3855 N Parkway Dr Apt 3a
Northbrook, IL 60062-7218

Phone

(847) 239-3654

NPI assigned

May 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1154944478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 N PARKWAY DR APT 3A",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627218",
            "telephone_number": "847-239-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 N PARKWAY DR APT 3A",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627218",
            "telephone_number": "847-239-3654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDAK",
        "first_name": "DIANA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "238000628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Gobby, PSY.D.
• Patricia Gobel, LCSW
• Carly Goebel
• Gold Counseling Services, P.C.
• Julie H Gold, LCSW
• Benjamin James Goldberg, LCPC
• Julie S Goldberg, MD
• Salmon S Goldberg, M.D.
• Harris S Goldenberg, M.D.
• Bari Lisa Goldman Cohen, PH.D.

• Surgical Physician Assistant in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.