Individual provider · NPI-1

Michael Joseph Gootee, MD

Otolaryngology, Plastic Surgery within the Head & Neck · Peoria, IL

NPI number1720050982

StatusActive

Last updated in NPPESMar 20, 2018

Details

NPI: 1720050982
Entity type: Individual (NPI-1)
Name: Mr. Michael Joseph Gootee
Credential: MD
Sex: Male
Sole proprietor: No
Enumeration date: Feb 2, 2006
Last updated: Mar 20, 2018

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207YX0007X	Otolaryngology, Plastic Surgery within the Head & Neck	036090454	IL	Yes

Practice location

420 Ne Glen Oak Ave
Peoria, IL 61603-3105

Phone 309-655-4180 · Fax 309-655-3948

Mailing address

420 Ne Glen Oak Ave
Peoria, IL 61603-3105

Phone 309-655-4180 · Fax 309-655-3948

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