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Contact Information

STEPHANIE H GOEDE, PA-C
420 N IL ROUTE 31
CRYSTAL LAKE, IL60012
 Phone: 815-356-5200
 Fax: 815-356-5262
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for STEPHANIE H GOEDE · (Female)

NPI Number 1548519986
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/30/2012
Last updated 06/07/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 085.004468
  • IL Other 1108763 NCCPA
  • IL Other 085004468 STATE LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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