Individual
DR. STEPHEN D GABRIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 E 1ST ST, STE 305 KSB MEDICAL GROUP, DIXON, IL 61021
(815) 285-5800
(815) 285-5691
Mailing address
215 E 1ST ST STE 326, DIXON, IL 61021-3190
(815) 285-5800
(815) 285-5691
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-091184
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091184
—
IL
01
—
K05116
MEDICARE PTAN
IL
Enumeration date
01/27/2006
Last updated
09/04/2018
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