Individual
MALCOLM GEBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
645 S CENTRAL AVE, CHICAGO, IL 60644-5059
(530) 410-7494
Mailing address
727 W MADISON ST APT 3603, CHICAGO, IL 60661-2579
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
125.083009
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125.083009
IL
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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