Umesh P Goswami, MD
Individual provider Active NPI Pediatrics Physician · Genoa, IL
NPI 1669466801 · NPPES record last updated May 12, 2017
Key facts
- NPI
- 1669466801
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 036058246 (IL)
- Practice address
- 599 Pearson Dr
Genoa, IL 60135-1355 - Phone
- (815) 784-6437
- Fax
- (815) 784-3933
- NPI assigned
- Sep 2, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umesh P. Goswami MD SC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036058246 | IL | Yes |
Addresses
Primary practice location
599 Pearson Dr
Genoa, IL 60135-1355
Mailing address
599 Pearson Dr
Genoa, IL 60135-1355
Phone (815) 784-6437
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036058246 | Medicaid | IL |
Other providers in Genoa, IL
- Family First Physicians SC
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- Genesis Enterprises Inc
- Genoa Kingston Cusd 424
- Genoa-Kingston Fire Protection District
- His Glory Transport LLC
- Erah M Hogan
- Mark E Jacobs
- Jeffrey T. Caron, P.C.
- Justin T. Durancik, DDS, PLLC
All providers in Genoa, IL · Pediatrics Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.