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Individual
DR. KEVIN SEAN GAVIN
Active
Individual
DR. KEVIN SEAN GAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004743
IL
213EP0504X
Public Medicine Podiatrist
016004743
IL
213EP1101X
Primary Podiatric Medicine Podiatrist
016004743
IL
213ER0200X
Radiology Podiatrist
016004743
IL
213ES0000X
Sports Medicine Podiatrist
016004743
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
016004743
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01606879
BLUE CROSS BLUE SHIELD
IL
01
—
480023961
RAILROAD MEDICARE
IL
01
—
5090108
AETNA
IL
Enumeration date
07/06/2006
Last updated
05/04/2020
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