Jennifer Gooch

Individual provider Active NPI Driver · Chicago, IL

NPI 1639006604 · NPPES record last updated May 5, 2026

Key facts

NPI
1639006604
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
Practice address
9356 S Colfax Ave
Chicago, IL 60617-4007
Phone
(847) 350-9326
NPI assigned
May 5, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver
Group: 193400000X SINGLE SPECIALTY GROUP
172A00000X IL Yes

Addresses

Primary practice location

9356 S Colfax Ave
Chicago, IL 60617-4007

Mailing address

9356 S Colfax Ave
Chicago, IL 60617-4007
Phone (847) 350-9326

Other providers in Chicago, IL

All providers in Chicago, IL · Driver in Illinois

Sources for this page

Verify at the official NPI Registry.