Individual
GARY B HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 E WISCONSIN AVE, MILWAUKEE, WI 53202-4815
(414) 290-6720
(414) 290-6755
Mailing address
3000 WOODCREEK DR, DOWNERS GROVE, IL 60515-5401
(630) 874-2994
(630) 968-1622
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036061845
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061845
—
IL
01
—
P00822024
RAILROAD MEDICARE
IL
Enumeration date
09/21/2006
Last updated
10/27/2015
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