Individual
JASON THOMAS GAMBLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-8000
Mailing address
7455 W WASHINGTON AVE STE 302, LAS VEGAS, NV 89128-4340
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012357877
OTHER
—
Enumeration date
09/14/2022
Last updated
09/14/2022
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