Active NPI
Diane M Goodman, NP APRN
- Registered Nurse
- Gurnee, IL
National Provider Identifier
1255397907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- Practice address
- 1445 N Hunt Club Road
Suite 102
Gurnee, IL 60031 - Phone
- (847) 855-2493
- Fax
- (847) 855-2490
- NPI assigned
- Apr 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | IL | Primary |
Addresses
Primary practice location
1445 N Hunt Club Road
Suite 102
Gurnee, IL 60031
Mailing address
9217 73Rd St
Kenosha, WI 53142
Phone (262) 942-7250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209005692 | IL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1255397907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9217 73RD ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "53142",
"telephone_number": "262-942-7250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1445 N HUNT CLUB ROAD",
"address_2": "SUITE 102",
"city": "GURNEE",
"state": "IL",
"postal_code": "60031",
"telephone_number": "847-855-2493",
"fax_number": "847-855-2490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "DIANE",
"middle_name": "M",
"credential": "NP APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gurnee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.