Individual
DR. DOUGLAS A GILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
217 55TH ST, CLARENDON HILLS, IL 60514-1525
(630) 850-7522
Mailing address
217 55TH ST, CLARENDON HILLS, IL 60514-1525
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036068005
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002201586
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/23/2007
Last updated
10/23/2007
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