NPI 1053511394

Edward Nmn Goldsborough, IDC

Practitioner Independent Duty Corpsman Great Lakes, IL

Practice location

Address: 3001 a 6th St, Great Lakes, IL 60088
Phone: (847) 688-4560
Mailing address: 8736 S 50th Ave, Oak Lawn, IL 60453-1340

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1053511394
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jul 2007
Record last updated: 24 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.