Provider Demographics
NPI:1316338239
Name:GOYAL, AMITA
Entity type:Individual
Prefix:
First Name:AMITA
Middle Name:
Last Name:GOYAL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 N ELM ST STE 306
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3625
Mailing Address - Country:US
Mailing Address - Phone:630-323-5214
Mailing Address - Fax:
Practice Address - Street 1:908 N ELM ST STE 315
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3625
Practice Address - Country:US
Practice Address - Phone:630-323-5214
Practice Address - Fax:630-323-5215
Is Sole Proprietor?:No
Enumeration Date:2015-02-13
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-146730207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine