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Individual

GABRIEL ILLOVSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
901 W BEN WHITE BLVD, AUSTIN, TX 78704-6903
(512) 447-2211
Mailing address
312 W ELTING ST, MACOMB, IL 61455-1132
(309) 259-9090

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1071166
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
1071166
TX

Other

Enumeration date
04/15/2022
Last updated
08/05/2022
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