Individual
KEITH R GABRIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1041
(217) 757-6535
(217) 757-6536
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-7578
(217) 545-1884
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036078399
IL
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
036-078399
IL
Other
Enumeration date
09/26/2005
Last updated
07/31/2013
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