Provider Demographics
NPI:1699768721
Name:GOYAL, RAJ KAMAL (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:RAJ
Middle Name:KAMAL
Last Name:GOYAL
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7456 S STATE RD STE 302
Mailing Address - Street 2:
Mailing Address - City:BEDFORD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60638-6625
Mailing Address - Country:US
Mailing Address - Phone:773-873-0052
Mailing Address - Fax:773-873-0054
Practice Address - Street 1:7456 S STATE RD STE 302
Practice Address - Street 2:
Practice Address - City:BEDFORD PARK
Practice Address - State:IL
Practice Address - Zip Code:60638-6625
Practice Address - Country:US
Practice Address - Phone:773-873-0052
Practice Address - Fax:773-873-0054
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036106534207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036106534Medicaid
IL215002Medicare PIN