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DR. RHODA JEAN GOTTFRIED M.D. NPI 1922212638


NPI Information

NPI: 1922212638
Provider Name: DR. RHODA JEAN GOTTFRIED, M.D.
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

PECOS Registration: Yes

Address:
3024 E EMPIRE ST
2ND FLOOR SUITE A
BLOOMINGTON, IL
ZIP 61704
Phone: (309) 556-7800
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DR. Rhoda Jean Gottfried, M.D. is a child and adolescent psychiatry psychiatry neurology in Bloomington, IL with 20 years of experience. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. DR. Rhoda Jean Gottfried, M.D. NPI is 1922212638. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3024 E EMPIRE ST
2ND FLOOR SUITE A
BLOOMINGTON, IL
ZIP 61704-402
Phone: (309) 556-7800
Fax: (309) 556-7804

The NPI 1922212638 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/10/2007 and was last updated on 10/19/2016.


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
12084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry036.131825ILLINOISYes

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
1036482700MEDICAIDMARYLAND
2192272Y8KMEDICARE PINMARYLAND

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.