Organization
BRUCE A. GOBER MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE GOBER M.D. (PRESIDENT)
(773) 213-5016
Entity
Organization
Contact information
Practice address
3300 N LAKE SHORE DR, APT 5A, CHICAGO, IL 60657-3957
(773) 213-5016
Mailing address
3300 N LAKE SHORE DR, APT 5A, CHICAGO, IL 60657-3957
(773) 213-5016
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036045996
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036045996
—
IL
Enumeration date
08/15/2006
Last updated
02/19/2016
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