Individual provider Active NPI

William A. Goodfellow, M.D.

  • General Practice Physician
  • Geneva, IL
National Provider Identifier
1770823585
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036-042732 Issued in IL
Practice address
1010 S. Batavia Ave.
Geneva, IL 60134
Phone
(630) 337-9490
NPI assigned
Feb 15, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 036-042732 IL Primary

Addresses

Primary practice location

1010 S. Batavia Ave.
Geneva, IL 60134

Mailing address

1010 S. Batavia Ave.
Geneva, IL 60134
Phone (630) 337-9490

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-042732ILMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1360886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1770823585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 S. BATAVIA AVE.",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "60134",
            "telephone_number": "630-337-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S. BATAVIA AVE.",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "60134",
            "telephone_number": "630-337-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODFELLOW",
        "first_name": "WILLIAM",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-15",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036-042732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; 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.