Provider Demographics
NPI:1841400272
Name:GOODMAN, JILL C (MD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:C
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3220 REDHAWK ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-8500
Mailing Address - Country:US
Mailing Address - Phone:319-325-3600
Mailing Address - Fax:
Practice Address - Street 1:2769 HEARTLAND DR
Practice Address - Street 2:SUITE 201
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2732
Practice Address - Country:US
Practice Address - Phone:319-337-3139
Practice Address - Fax:319-545-4570
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA39106207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology