DR. RHODA JEAN GOTTFRIED (NPI# 1922212638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922212638 |
| Entity Type | Individual |
| Full Name | DR. RHODA JEAN GOTTFRIED |
| Credential | M.D. |
| Practice Address |
3024 E Empire St 2nd Floor Suite A Bloomington IL 61704-5402 |
| Practice Telephone | 3095567800 |
| Practice Fax Number | 3095567804 |
| Mailing Telephone | 3095567800 |
| Mailing Fax Number | 3095567804 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2016-10-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
036.131825 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 036482700 | 05 |
| Street Address |
3024 E EMPIRE ST 2ND FLOOR SUITE A |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-5402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538700851 | Cameron Troy Jackson Stengel | Physician Assistant | 3024 E Empire St, Bloomington, IL 61704-5402 | 2019-10-08 |
| 1497206551 | Jennifer Victoria Menendez | Physician Assistant | 3024 E Empire St, Bloomington, IL 61704-5402 | 2016-10-24 |
| 1578951075 | Desha Cobb | Nurse Practitioner | 3024 E Empire St, Bloomington, IL 61704-5402 | 2015-01-06 |
| 1770989220 | Jennifer Gibb | Nurse Practitioner | 3024 E Empire St, Bloomington, IL 61704 | 2014-11-11 |
| 1770828626 | Dermatology and Mohs Surgery Institute, Ltd. | Specialist | 3024 E Empire St, 2nd Floor, Suite F, Bloomington, IL 61704-5402 | 2012-12-04 |
| 1902131014 | David Milligan | Pediatrics | 3024 E Empire St, Bloomington, IL 61704-5402 | 2009-10-07 |
| 1285804724 | Andrea Michelle Kane | Pediatrics | 3024 E Empire St, Bloomington, IL 61704-5402 | 2008-03-11 |
| 1083890156 | Aaron Reid Traeger | Pediatrics | 3024 E Empire St, Bloomington, IL 61704-5402 | 2008-01-18 |
| 1255523296 | Douglas Michael Leone | Dermatology | 3024 E Empire St, Ste E & F, Bloomington, IL 61704-5402 | 2007-08-14 |
| 1982800876 | Sasikala Royyuru | Family Medicine | 3024 E Empire St, Bloomington, IL 61704-5402 | 2007-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
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|---|---|---|---|---|
| 1144851684 | Greywood Health Center LLC | Psychiatry & Neurology | 303 W Institute Pl Fl 3, Chicago, IL 60610-3080 | 2020-02-03 |
| 1285273540 | Tms Clinical Services Pllc | Psychiatry & Neurology | 1100 Jorie Blvd Ste 172, Oak Brook, IL 60523-4409 | 2020-01-03 |
| 1942702386 | Brain and Wellness Institute LLC | Psychiatry & Neurology | 30 W Oak St Apt 14a, Chicago, IL 60610-8724 | 2018-03-01 |
| 1598278749 | Elemental Treatment Center Ltd | Psychiatry & Neurology | 612 S Western Ave Apt 1, Chicago, IL 60612-4682 | 2017-11-09 |
| 1225404551 | Family Renewed, LLC | Psychiatry & Neurology | 1004 Pebble Beach Dr, Caseyville, IL 62232-2834 | 2015-08-21 |
| 1487032082 | Jerry Francisco Benzl | Psychiatry & Neurology | 1740 Taylor St., Chicago, IL 60612 | 2015-05-14 |
| 1942697800 | Dr Mo S.c | Psychiatry & Neurology | 2131 W Silverleaf Ln, Addison, IL 60101-6404 | 2015-04-17 |
| 1104234046 | Hitekshya Nepal | Psychiatry & Neurology | 5230 6th Street Frontage Rd E, Springfield, IL 62703-5128 | 2014-07-23 |
| 1740558261 | Jyoti Shah | Psychiatry & Neurology | 1335 N Mill St Ste 100, Naperville, IL 60563-2047 | 2011-12-12 |
| 1083921530 | Jodi Chase | Psychiatry & Neurology | 480 Elm Pl Ste 106, Highland Park, IL 60035-2535 | 2010-09-04 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
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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.