Provider Demographics
NPI:1588879571
Name:GOLDMAN, ROBERT M (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:15 S MCHENRY RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6705
Mailing Address - Country:US
Mailing Address - Phone:847-618-0326
Mailing Address - Fax:847-618-0762
Practice Address - Street 1:15 S MCHENRY RD
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-6705
Practice Address - Country:US
Practice Address - Phone:847-618-0326
Practice Address - Fax:847-618-0762
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036122041207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00738112CG6042OtherRR MEDICARE
WIGOLDMRO2OtherMERCYCARE INSURANCE
IL510420002Medicare PIN
WIGOLDMRO2OtherMERCYCARE INSURANCE