Richard S. Goldberg, M.D., LTD.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036056868 Issued in IL

Legal business name

RICHARD S. GOLDBERG, M.D., LTD.

Practice address

8311 Roosevelt Rd
Optional
Forest Park, IL 60130-2529

Phone

(708) 814-6600

Fax

(630) 920-9095

NPI assigned

Jan 11, 2011

Organization subpart

No

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

Authorized official

Name

Richard Goldberg, MD

Title

President

Phone

(708) 814-6600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1427353184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8311 ROOSEVELT RD",
            "address_2": "OPTIONAL",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302529",
            "telephone_number": "708-814-6600",
            "fax_number": "630-920-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8311 ROOSEVELT RD",
            "address_2": "OPTIONAL",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601302529",
            "telephone_number": "708-814-6600",
            "fax_number": "630-920-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD S. GOLDBERG, M.D., LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-814-6600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036056868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036056868",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Forest Park, IL
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.