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Individual

DR. STEVEN GITELIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036053564
IL
2086X0206X
Surgical Oncology Physician
036053564
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036053564 1
IL
01
1633878
BCBS GROUP ID#
IL
01
207067
MEDICARE PTAN LOCALITY 16
IL
01
207073
MEDICARE PTAN LOCALITY 15
IL
01
4028614
AETNA ID#
IL
01
DA4902
RR MEDICARE PTAN#
IL
01
P00231217
RR MEDICARE ID#
IL
Enumeration date
01/11/2006
Last updated
10/09/2018
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