Individual
MR. GERARD GEURTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7 BLANCHARD CIR, WHEATON, IL 60189-2037
(630) 926-4337
(630) 653-0988
Mailing address
7 BLANCHARD CIR, WHEATON, IL 60189-2037
(630) 653-0848
(630) 653-0988
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001584
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550894537
TAX ID
IL
01
—
920540
MEDICARE PTAN (GROUP)
IL
01
—
F400104135
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
K03094
MCR
—
01
—
K18826
MCR ID
—
Enumeration date
11/16/2005
Last updated
12/19/2013
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