DR. EDWARD J. GOLDBERG (NPI# 1407835176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407835176 |
| Entity Type | Individual |
| Full Name | DR. EDWARD J. GOLDBERG |
| Credential | M.D. |
| Practice Address |
1611 W Harrison St Ste 400 Chicago IL 60612-3841 |
| Mailing Address |
1 Westbrook Corporate Ctr #240 Westchester IL 60154-5701 |
| Practice Telephone | 3122434244 |
| Practice Fax Number | 3129421517 |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2018-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
036070258 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE PTAN LOCALITY 16 | 207067 | 01 |
| IL | MEDICARE PTAN LOCALITY 15 | 207073 | 01 |
| IL | RR MEDICARE ID# | P00150808 | 01 |
| IL | RR MEDICARE PTAN# | DA4902 | 01 |
| IL | BCBS GROUP ID# | 1633878 | 01 |
| IL | AETNA ID# | 4122886 | 01 |
| IL | 036070258 3 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466202 | Edward Goldberg | Pharmacist | 180 Levitttown Pkwy, Levittown, PA 19055 | 2020-10-30 |
| 1952580904 | Edward A Goldberg | Psychiatry & Neurology | 12264 El Camino Real Ste 303, San Diego, CA 92130 | 2007-10-26 |
| 1639211105 | Edward M Goldberg | Optometrist | 7 Montauk Court, Westbury Hills, NY 11590-2725 | 2007-02-13 |
| 1235167768 | Edward S Goldberg | Internal Medicine | 121 East 60th Street, New York, NY 10022 | 2006-06-30 |
| 1770857799 | Edward H Goldberg Iv | Dentist | 1625 Glenns Bay Rd, Surfside Beach, SC 29575-4836 | 2012-03-08 |
| 1699701433 | Edward C Goldberg | Radiology | 6245 Inkster Rd, Garden City, MI 48135-4001 | 2006-06-23 |
| Street Address |
1611 W HARRISON ST STE 400 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235138546 | Thomas J Nielsen | Otolaryngology | 1611 W Harrison St, Suite 550, Chicago, IL 60612-4861 | 2005-07-19 |
| 1699376996 | Lauren Kennerly | Registered Nurse | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-11-03 |
| 1225677404 | Mary Kathleen Walsh | Orthopaedic Surgery | 1611 W Harrison St, Chicago, IL 60612-4861 | 2020-01-05 |
| 1407417900 | Megan Merritt | Specialist/Technologist | 1611 W Harrison St, Chicago, IL 60612-4861 | 2019-06-25 |
| 1881253292 | Ellen Rohan | Physician Assistant | 1611 W Harrison St, Chicago, IL 60612-4861 | 2019-06-10 |
| 1588136154 | Elle Steele | Physician Assistant | 1611 W Harrison St, Chicago, IL 60612-4861 | 2018-12-20 |
| 1720591704 | Tricia Jacobs | Speech-Language Pathologist | 1611 W Harrison St, Chicago, IL 60612-4861 | 2017-11-13 |
| 1811415227 | Emily Marie Krogel | Nurse Practitioner | 1611 W Harrison St, Chicago, IL 60612-4861 | 2017-09-06 |
| 1104376912 | Paige Maher | Physician Assistant | 1611 W Harrison St, Ste 300, Chicago, IL 60612-4861 | 2016-10-05 |
| 1902350929 | Leah Kathleen Sparker | Specialist/Technologist | 1611 W Harrison St, Orthopedic Building Suite 530, Chicago, IL 60612-4861 | 2016-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609940972 | Giri T Gireesan | Orthopaedic Surgery | 676 North St Clair St, #1777, Chicago, IL 60611 | 2006-11-20 |
| 1346278017 | Mark J. Sokolowski | Orthopaedic Surgery | 1743 N Harlem Ave, Chicago, IL 60707-4305 | 2006-06-29 |
| 1134506405 | Nicholas Alan Shepard | Orthopaedic Surgery | 1611 W Harrison St, Chicago, IL 60612-4861 | 2015-05-06 |
| 1578974994 | Krishn Khanna | Orthopaedic Surgery | 1611 W Harrison St Ste 300, Chicago, IL 60612-4861 | 2014-05-20 |
| 1619242799 | Julie M. Wehner Md Sc | Orthopaedic Surgery | 3000 N Halsted St, Suite 611, Chicago, IL 60657-5188 | 2012-03-21 |
| 1396045464 | Mark J Sokolowski Md Sc | Orthopaedic Surgery | 1743 N Harlem Ave, Chicago, IL 60707-4305 | 2010-10-23 |
| 1366754699 | Gregory David Lopez | Orthopaedic Surgery | 1611 W Harrison St, Ste 300, Chicago, IL 60612-4861 | 2010-07-01 |
| 1205002607 | Matthew Wesley Colman | Orthopaedic Surgery | 1611 W Harrison St, Ste 300, Chicago, IL 60612-4861 | 2008-05-06 |
| 1740358308 | Purnendu Gupta | Orthopaedic Surgery | 2211 North Oak Park Avenue, Suite 3a, Chicago, IL 60707-3329 | 2006-12-01 |
| 1952334948 | Christopher J Dewald | Orthopaedic Surgery | 1611 W Harrison St, Ste 400, Chicago, IL 60612-3841 | 2006-07-10 |
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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.