Organization
MICHAEL M GELBORT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL M GELBORT PHD (OWNER)
(815) 230-2262
Entity
Organization
Contact information
Practice address
2714 CATON FARM RD, JOLIET, IL 60435-1309
(815) 230-2262
Mailing address
2714 CATON FARM RD, JOLIET, IL 60435-1309
(815) 230-2262
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
07100400
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9904511
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/23/2007
Last updated
02/14/2014
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