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SHERRIE C. GODBOLT MD SC NPI 1073767505


NPI Information

NPI: 1073767505
Provider Name: SHERRIE C. GODBOLT MD SC
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

Address:
15475 S PARK AVE
SUITE 111
SOUTH HOLLAND, IL
ZIP 60473
Phone: (708) 362-5084
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SHERRIE C. GODBOLT MD SC is a psychiatry psychiatry neurology in South Holland, IL. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. SHERRIE C. GODBOLT MD SC NPI is 1073767505. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

15475 S PARK AVE
SUITE 111
SOUTH HOLLAND, IL
ZIP 60473-328
Phone: (708) 362-5084
Fax: (708) 596-6985

The provider's authorized official is Sherrie Cecile Godbolt .
The authorized official title is Psychiatrist and has the following contact phone number (708) 362-5084.

The enumeration date for this NPI number is 11/11/2008 and was last updated on 11/11/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0800XPsychiatry & NeurologyPsychiatry036098066ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1530140MEDICARE PINILLINOIS
2G16707MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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