Organization
DOUGLAS GILL MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS ARTHUR GILL MD (PRESIDENT)
(630) 850-7522
Entity
Organization
Contact information
Practice address
217 55TH ST, CLARENDON HLS, IL 60514-1525
(630) 850-7520
(630) 850-7514
Mailing address
217 55TH ST, CLARENDON HLS, IL 60514-1525
(630) 850-7520
(630) 850-7514
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036068005
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02201586
BCBS
IL
Enumeration date
09/02/2005
Last updated
10/10/2007
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