NPIMap

Organization Active NPI

Barry R. Goldberg, M.D. LLC

  • Internal Medicine Physician
  • Highland Park, IL
National Provider Identifier
1659528784
Registry record updated Aug 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036061202 Issued in IL
Legal business name
BARRY R. GOLDBERG, M.D. LLC
Practice address
767 Park Ave W
Suite 330
Highland Park, IL 60035-2400
Phone
(847) 433-1709
Fax
(847) 681-8251
NPI assigned
Aug 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2009

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

Authorized official

Name
Dr. Barry R. Goldberg, M.D.
Title
MD/Physician
Phone
(847) 433-1709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036061202 IL Primary

Addresses

Primary practice location

767 Park Ave W
Suite 330
Highland Park, IL 60035-2400

Mailing address

767 Park Avenue
Suite 330
Highland Park, IL 60035-3109
Phone (847) 433-1709

Other names 1

  • Personalized Healthcare Other name

National Provider Directory

National Provider Directory

Locations

767 Park Ave W
Ste 3
Highland Park, IL 60035
Phone (847) 433-1709

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1659528784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 PARK AVENUE",
            "address_2": "SUITE 330",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353109",
            "telephone_number": "847-433-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 PARK AVE W",
            "address_2": "SUITE 330",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352400",
            "telephone_number": "847-433-1709",
            "fax_number": "847-681-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY R. GOLDBERG, M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-20",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MD/PHYSICIAN",
        "authorized_official_telephone_number": "847-433-1709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036061202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Personalized Healthcare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.