Individual
KEVIN PATRICK GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2800 W 95TH ST, EVERGREEN PARK, IL 60805-2701
(708) 422-6200
(708) 499-8510
Mailing address
PO BOX 631, LAKE FOREST, IL 60045-0631
(847) 615-2200
(847) 615-2858
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041329798
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209008279
IL
Other
Enumeration date
09/21/2010
Last updated
10/11/2023
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