DR. MUKUND GODBOLE (NPI# 1003996125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003996125 |
| Entity Type | Individual |
| Full Name | DR. MUKUND GODBOLE |
| Credential | M.D. |
| Practice Address |
1000 W Harlem Ave Monmouth IL 61462-1007 |
| Practice Telephone | 3097343141 |
| Mailing Telephone | 3097343141 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2014-05-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 17209 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | PALMETTO MEDICARE RAILROA | P00269826 | 01 |
| MS | MEDICARE CAHABA | C03242 | 01 |
| MS | 02820846 | 05 |
| Street Address |
1000 W HARLEM AVE |
| City | MONMOUTH |
| State | IL |
| Zip Code | 61462-1007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265432363 | Community Medical Center of Western Il Inc | Home Health | 1000 W Harlem Ave, Monmouth, IL 61462-1007 | 2005-07-29 |
| 1285253997 | Catherine Jane Steck | Physical Therapist | 1000 W Harlem Ave, Monmouth, IL 61462-1007 | 2020-04-13 |
| 1205482254 | Tonya Renee Gibbs | Nurse Practitioner | 1000 W Harlem Ave, Monmouth, IL 61462-1007 | 2019-08-15 |
| 1285193441 | Carrie Anne Green | Nurse Practitioner | 1000 W Harlem Ave, Monmouth, IL 61462-1007 | 2019-03-18 |
| 1700399516 | Osf Healthcare System | Emergency Medicine | 1000 W Harlem Ave, Monmouth, IL 61462-1007 | 2017-11-15 |
| 1508396045 | Tina Gayle Canada | Registered Nurse | 1000 W Harlem Ave, Monmouth, IL 61462-1007 | 2017-06-18 |
| 1972058063 | Nancy J Nelson-beliveau | Nurse Practitioner | 1000 W Harlem Ave, Monmouth, IL 61462-1007 | 2016-08-18 |
| 1477964880 | Michael Raymond | Counselor | 1000 W Harlem Ave, Monmouth, IL 61462-1007 | 2014-05-20 |
| 1972739548 | Sheila Raedine Feaster | Podiatrist | 1000 W Harlem Ave, Monmouth, IL 61462-1007 | 2009-06-09 |
| 1871763458 | Dr Byung Il Hyun Md | Radiology | 1000 W Harlem Ave, Monmouth, IL 61462-1007 | 2008-03-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740806942 | Michelle N Smith | Registered Nurse | 1220 E. 2nd Avenue, Monmouth, IL 61462 | 2020-06-23 |
| 1518413103 | Daniel Chard | Emergency Medical Technician, Basic | 331 S. 6th St, Monmouth, IL 61462 | 2016-09-01 |
| 1174079388 | Patrick Spears | Emergency Medical Technician, Paramedic | 601 Industrial Park Road, Monmouth, IL 61462 | 2016-08-28 |
| 1326222993 | Terri Lynn Gittings | Registered Nurse | Industrial Park Road, Bridgeway Inc, Monmouth, IL 61462 | 2007-12-19 |
| 1811011422 | Hancock Mcdonough Roe 21 | Local Education Agency (LEA) | 1301 N Main, Ste 3, Monmouth, IL 61462 | 2007-03-19 |
| 1295870137 | Warren Achievement Center Inc | Case Management | 1220 East Second Avenue, Monmouth, IL 61462 | 2007-02-20 |
| 1265527931 | Petersen Health Systems, Ins | Assisted Living Facility | 1 Courtyard Blvd, Monmouth, IL 61462-1086 | 2006-10-04 |
| 1881759678 | Clyde Don Elswick | Registered Nurse | 1000 West Harlem Avenue, Monmouth, IL 61462-1099 | 2006-12-22 |
| 1447239728 | Community Medical Center of Western Illinois Inc | Skilled Nursing Facility | 1000 W Harlem Avenue, Monmouth, IL 61462-1099 | 2006-01-13 |
| 1023095437 | Community Medical Center of Western Illinois Inc | Clinic/Center | 1000 West Harlem Ave, Monmouth, IL 61462-1099 | 2005-12-28 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1376167809 | Francesco Bajani | Surgery | 664 N Dearborn St Apt 2f, Chicago, IL 60654-3848 | 2020-06-01 |
| 1972123099 | Andrea Liu | Surgery | 5841 S Maryland Ave Mc6040, Chicago, IL 60637-1443 | 2020-04-18 |
| 1750917183 | Alberto Maria Fratti | Surgery | 901 S Ashland Ave Apt 711, Chicago, IL 60607-4088 | 2020-03-17 |
| 1841845047 | Barijuve Surgical LLC | Surgery | 380 E Northwest Hwy Ste 200, Des Plaines, IL 60016-2274 | 2019-08-05 |
| 1164081782 | Sean Park | Surgery | 1739 Tudor Ln Unit 308, Northbrook, IL 60062-3778 | 2019-06-07 |
| 1376014175 | Edwardsville Physicians Group LLC | Surgery | 441 South State Route 157 Suite 102, Edwardsville, IL 62025-4012 | 2018-12-06 |
| 1316421324 | Erica Lester | Surgery | John H Stroger, 1969 Ogden Ave, Chicago, IL 60612 | 2018-09-17 |
| 1023513389 | Crystal Siyu Zhang | Surgery | 2160 S 1st Ave Bldg 3210, Maywood, IL 60153 | 2018-03-28 |
| 1376047381 | Richard Lawrence Nelson | Surgery | 1603 W. Taylor St., Room 983, Chicago, IL 60612-4394 | 2018-03-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.