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Individual
STEPHEN R GAWNE
Active
Individual
STEPHEN R GAWNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36071083
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036071083
—
IL
01
—
487450005
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
920540
MEDICARE PTAN (GROUP)
IL
01
—
F400163079
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
02/15/2006
Last updated
11/06/2014
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