Provider Demographics
NPI:1255387007
Name:GOEL, RAM (MD)
Entity type:Individual
Prefix:DR
First Name:RAM
Middle Name:
Last Name:GOEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:920 WEST ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-2763
Mailing Address - Country:US
Mailing Address - Phone:815-223-6222
Mailing Address - Fax:815-233-3838
Practice Address - Street 1:920 WEST ST
Practice Address - Street 2:SUITE 116
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-2763
Practice Address - Country:US
Practice Address - Phone:815-223-6222
Practice Address - Fax:815-233-3838
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC44157Medicare UPIN
IL623663Medicare ID - Type UnspecifiedMEDICARE CLAIM NUMBER