Provider Demographics
NPI:1114701224
Name:GOES, COURTNEY MARIE
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:GOES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18213 NEWCASTLE CT
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487-9574
Mailing Address - Country:US
Mailing Address - Phone:708-770-9368
Mailing Address - Fax:
Practice Address - Street 1:18213 NEWCASTLE CT
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-9574
Practice Address - Country:US
Practice Address - Phone:708-770-9368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist