Dr Sherrie Cecile Godbolt, MD is a
Psychiatry & Neurology - Psychiatry physician based in South Holland, Illinois. Dr Sherrie Cecile Godbolt is licensed to practice in Illinois (license number 036098066) and her current practice location is 15475 S Park Ave, Suite 111, South Holland, Illinois. She can be reached at her office (for appointments etc.) via phone at
(708) 362-5084.
NPI number for Dr Sherrie Cecile Godbolt is 1114027828 and her current mailing address is 15475 S Park Ave, Suite 111, South Holland, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1114027828.
Physician's Profile
| Full Name | Dr Sherrie Cecile Godbolt |
|---|
| Gender | Female |
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| Speciality | Psychiatry & Neurology - Psychiatry |
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| Location | 15475 S Park Ave, South Holland, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1114027828
- Provider Enumeration Date: 09/23/2006
- Last Update Date: 01/14/2013
Medical Identifiers
Medical identifiers for Dr Sherrie Cecile Godbolt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114027828 | NPI | - | NPPES |
| 200197180 | Medicaid | IN | |
| 036098066 | Medicaid | IL | |
| 01625468 | Other | IL | BCBS PROVIDER ID |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036098066 (Illinois) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 01048641A (Indiana) | Secondary |
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | 036098066 (Illinois) | Secondary |
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | 01048641A (Indiana) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Sherrie Cecile Godbolt is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Sherrie Cecile Godbolt, MD
15475 S Park Ave, Suite 111,
South Holland, IL 60473-1328
Ph: (708) 362-5084 | Dr Sherrie Cecile Godbolt, MD
15475 S Park Ave, Suite 111,
South Holland, IL 60473-1328
Ph: (708) 362-5084 |
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