IndividualActive
Chetmira Gray Goggins
NPI 1205795390 · Early Intervention Provider Agency · Park Forest, IL
Provider details
- NPI number
- 1205795390
- Entity type
- Individual
- Primary specialty
- Early Intervention Provider AgencyAgencies
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Agencies
Practice location
539 Homan Ave
Park Forest, IL 60466-1068
Phone: (773) 297-9568
Approximate (ZIP-level) locationGet directions
Mailing address
539 Homan Ave
Park Forest, IL 60466-1068
Registry dates
- Enumerated
- 2026-01-15
- Last updated
- 2026-01-15
- Certified
- 2026-01-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.