Provider Demographics
NPI:1255443537
Name:GOLDRATH, DAVID E (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:GOLDRATH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:22285 PEPPER ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-0301
Mailing Address - Country:US
Mailing Address - Phone:847-382-5080
Mailing Address - Fax:847-382-0923
Practice Address - Street 1:22285 N PEPPER RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2538
Practice Address - Country:US
Practice Address - Phone:847-382-5080
Practice Address - Fax:847-382-0923
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-12-28
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Provider Licenses
StateLicense IDTaxonomies
IL036076688208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036076688Medicaid