NPIMap

Individual provider Active NPI

Pamela Denise Goodwin-Cole, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1306877329
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036076189 Issued in IL
Practice address
2734 W 87TH St
Chicago, IL 60652-3937
Phone
(773) 918-4700
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036076189 IL Primary

Addresses

Primary practice location

2734 W 87TH St
Chicago, IL 60652-3937

Mailing address

1395 NW 167TH St
Miami, FL 33169-5710
Phone (305) 628-6117

Other practice location 1

9401 S Pulaski Rd
Suite 101
Evergreen Park, IL 60805-1924
Phone (708) 424-2475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041014000609 IL Practitioner - Internal Medicine 5092792671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ucm Medical Group Sub LLCGroup PAC ID 4688635337, 101 clinicians

Practice addresses (Care Compare)

1 Ingalls Dr
Harvey, IL 60426-3558
Phone (708) 333-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036076189ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ucm Medical Group Sub, LLC Internal Medicine CurrentSince Dec 6, 2021 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

27702 Network Pl
Chicago, IL 60673

19550 Governors Hwy
Ste 2000
Flossmoor, IL 60422
Phone (708) 272-6606

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

Interoperability endpoints

  • Direct secure messaging: pgoodwincole224774@uchospital.direct-ci.com

Organizations & group practices 1

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 7

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1306877329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "305-628-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2734 W 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523937",
            "telephone_number": "773-918-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9401 S Pulaski Rd",
            "address_2": "SUITE 101",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608051924",
            "country_code": "US",
            "telephone_number": "708-424-2475",
            "fax_number": "708-424-2494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODWIN-COLE",
        "first_name": "PAMELA",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036076189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.