Individual
MICHAEL M GELBORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2714 CATON FARM RD, JOLIET, IL 60435-1309
(815) 230-2262
(815) 230-2444
Mailing address
PO BOX 437, HIGHLAND PARK, IL 60035-0437
(815) 230-2262
(815) 230-2444
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
07100400
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9904511
BLUE CROSS BLUE SHIELD
IL
01
—
P00057668
RAILROAD MEDICARE
IL
Enumeration date
11/09/2006
Last updated
07/08/2007
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