Individual
NICOLE M GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22285 N PEPPER RD STE 311, LAKE BARRINGTON, IL 60010-2541
(847) 382-4410
Mailing address
22285 N PEPPER RD STE 311, LAKE BARRINGTON, IL 60010-2541
(847) 382-4410
(815) 968-9453
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.134432
IL
207R00000X
Internal Medicine Physician
55286
MN
207RG0100X
Gastroenterology Physician
Primary
036.134432
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
06/01/2011
Last updated
09/28/2020
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