Kevin James Goodwin, M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Maywood, IL. Individual provider (NPI-1).
NPI number1124448832
StatusActive
Last updated in NPPESFeb 7, 2024
Details
- NPI
- 1124448832
- Entity type
- Individual (NPI-1)
- Name
- Kevin James Goodwin
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 21, 2014
- Certification date
- Feb 7, 2024
- Last updated
- Feb 7, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 36163802 | IL | Yes |
| 208600000X | Surgery | 61541 | MN | |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4301506962 | MI | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
2160 S 1st AveMaywood, IL 60153-3328
Phone 708-216-9000
Mailing address
3621 S State StAnn Arbor, MI 48108-1633
Phone 734-647-5299
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