Provider Demographics
NPI:1962610477
Name:GOESEL, ANDEW (DC)
Entity type:Individual
Prefix:DR
First Name:ANDEW
Middle Name:
Last Name:GOESEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 LAUREL HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-4014
Mailing Address - Country:US
Mailing Address - Phone:708-717-6062
Mailing Address - Fax:
Practice Address - Street 1:3985 SWIFT RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-6540
Practice Address - Country:US
Practice Address - Phone:941-218-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-007092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001683022OtherOTHER
IL1033277538OtherGOESEL CHIROPRACTIC NPI
IL0031640430OtherBCBS OF ILLINOIS
IL0031640430OtherBCBS OF ILLINOIS
IL1033277538OtherGOESEL CHIROPRACTIC NPI